PMID: 8607665Apr 1, 1996Paper

Onset timing of delayed complications and criteria of follow-up after operation for esophageal achalasia

The Annals of Thoracic Surgery
M P Di SimoneS Mattioli

Abstract

The purpose of this study was to define the length of follow-up necessary to obtain definitive results of the Heller myotomy for the therapy of esophageal achalasia and the modalities of long-term follow-up. Insufficient myotomy, periesophageal scarring, and gastroesophageal reflux esophagitis are the most common late complications of operation for achalasia. Columnar-lined esophagus with or without dysplasia and cancer can further complicate postoperative reflux esophagitis. Because progressive worsening of results with time has been reported, we assessed the timing of appearance of these complications. Since 1973, 129 patients submitted to Heller myotomy were clinically and objectively followed up. Mean follow-up was 97.4 months (range, 12 to 268 months). Of 129 patients, 42 were followed up for less than 5 years (17 voluntary drop outs, 10 reoperations, 3 deaths, 12 in follow-up), 47 more than 5 years, 26 more than 10 years, 12 more than 15 years, and 2 more than 20 years. The timing of onset of symptoms and complications related to the myotomy were evaluated as was the development of dysplasia and cancer. In 11 patients, severe dysphagia due to insufficient myotomy reappeared a mean of 12.4 months after the operation (range...Continue Reading

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Citations

Sep 20, 2007·Surgery Today·Naruo KawasakiKatsuhiko Yanaga
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Jan 31, 2021·The Annals of Thoracic Surgery·Valentina TassiSandro Mattioli

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