Abstract
Objectives: To study the pretreatment characteristics that predispose a patient to rupture and to compare the outcome after dilatation with the outcome after surgical myotomy. Design: A survey of all patients treated for achalasia at the Creighton University Medical Center, Omaha, Neb, during a 16-year period. Clinical examination and testing of consenting patients at 12 months and longer after treatment. Setting: Tertiary referral center. Patients: Of the 61 patients, 55 were treated with dilatation. Esophageal rupture developed in 8 patients (14.5%) with achalasia after pneumatic dilataion; these patients underwent surgery for the rupture. Dilatation failed in 8 other patients; these patients underwent a surgical myotomy. Six patients underwent a primary surgical myotomy. Main Outcome Measures: Duration of symptoms, weigth loss, lower esophageal sphincter resting pressure and relaxation, amplitude and quality of distal esophageal contractions (assessed by manometry), 24-hour esophageal pH, and maximal esophageal diameter (assessed by barium swallow examination). Results: Surgical myotomy at a mean (±SEM) of 44.9±18.6 months alleviated dysphagia in 13 (93%) of the 14 patients compared with only 12 (39%) of the 31 patients after dilation at a mean (±SEM) of 55.0±11.7 months (P
| Original language | English |
|---|---|
| Pages (from-to) | 233-240 |
| Number of pages | 8 |
| Journal | Archives of Surgery |
| Volume | 132 |
| Issue number | 3 |
| State | Published - 1997 |
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All Science Journal Classification (ASJC) codes
- Surgery
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Heller myotomy is superior to dilatation for the treatment of early achalasia. / Anselmino, Marco; Perdikis, Galen; Hinder, Ronald A.; Polishuk, Paul V.; Wilson, Paul; Terry, John D.; Lanspa, Stephen J.
In: Archives of Surgery, Vol. 132, No. 3, 1997, p. 233-240.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Heller myotomy is superior to dilatation for the treatment of early achalasia
AU - Anselmino, Marco
AU - Perdikis, Galen
AU - Hinder, Ronald A.
AU - Polishuk, Paul V.
AU - Wilson, Paul
AU - Terry, John D.
AU - Lanspa, Stephen J.
PY - 1997
Y1 - 1997
N2 - Objectives: To study the pretreatment characteristics that predispose a patient to rupture and to compare the outcome after dilatation with the outcome after surgical myotomy. Design: A survey of all patients treated for achalasia at the Creighton University Medical Center, Omaha, Neb, during a 16-year period. Clinical examination and testing of consenting patients at 12 months and longer after treatment. Setting: Tertiary referral center. Patients: Of the 61 patients, 55 were treated with dilatation. Esophageal rupture developed in 8 patients (14.5%) with achalasia after pneumatic dilataion; these patients underwent surgery for the rupture. Dilatation failed in 8 other patients; these patients underwent a surgical myotomy. Six patients underwent a primary surgical myotomy. Main Outcome Measures: Duration of symptoms, weigth loss, lower esophageal sphincter resting pressure and relaxation, amplitude and quality of distal esophageal contractions (assessed by manometry), 24-hour esophageal pH, and maximal esophageal diameter (assessed by barium swallow examination). Results: Surgical myotomy at a mean (±SEM) of 44.9±18.6 months alleviated dysphagia in 13 (93%) of the 14 patients compared with only 12 (39%) of the 31 patients after dilation at a mean (±SEM) of 55.0±11.7 months (P
AB - Objectives: To study the pretreatment characteristics that predispose a patient to rupture and to compare the outcome after dilatation with the outcome after surgical myotomy. Design: A survey of all patients treated for achalasia at the Creighton University Medical Center, Omaha, Neb, during a 16-year period. Clinical examination and testing of consenting patients at 12 months and longer after treatment. Setting: Tertiary referral center. Patients: Of the 61 patients, 55 were treated with dilatation. Esophageal rupture developed in 8 patients (14.5%) with achalasia after pneumatic dilataion; these patients underwent surgery for the rupture. Dilatation failed in 8 other patients; these patients underwent a surgical myotomy. Six patients underwent a primary surgical myotomy. Main Outcome Measures: Duration of symptoms, weigth loss, lower esophageal sphincter resting pressure and relaxation, amplitude and quality of distal esophageal contractions (assessed by manometry), 24-hour esophageal pH, and maximal esophageal diameter (assessed by barium swallow examination). Results: Surgical myotomy at a mean (±SEM) of 44.9±18.6 months alleviated dysphagia in 13 (93%) of the 14 patients compared with only 12 (39%) of the 31 patients after dilation at a mean (±SEM) of 55.0±11.7 months (P
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UR - http://www.scopus.com/inward/citedby.url?scp=0030938571&partnerID=8YFLogxK
M3 - Article
C2 - 9125019
AN - SCOPUS:0030938571
VL - 132
SP - 233
EP - 240
JO - JAMA Surgery
JF - JAMA Surgery
SN - 2168-6254
IS - 3
ER -