OPPORTUNITIES OF LAPAROSCOPY IN THE TREATMENT OF ESOPHAGEAL ACHALASIA
- Authors: Allakhverdyan A.S.1, Mazurin V.S.1, Frolov A.V.1, Anipchenko N.N.1
-
Affiliations:
- Moscow Regional Research and Clinical Institute
- Issue: No 40 (2015)
- Pages: 109-116
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/116
- DOI: https://doi.org/10.18786/2072-0505-2015-40-109-116
- ID: 116
Cite item
Full Text
Abstract
The article describes opportunities and results of laparoscopic oesophagocardiomiotomy and laparoscopic transhiatal oesophagus removal without hand assistance in esophageal achalasia (cardiospasm). In total, such operations were performed in 196 and 31 of cases (of 423 patients), respectively. There were minimal numbers of relapses (below 2.3%) after laparoscopic oesophagocardiomiotomy done by the proposed technique. All cases of reflux esophagitis were diagnosed after esophagocardiomiotomy with Dor fundoplication.
After cardiodilatation, disease relapses were registered in 57% of patients. The advantages of a laparoscopic access for oesophagectomy are shown and technical particular of this intervention are analyzed based on a case history. The principles of Fast track surgery in this patient category are discussed that allow for reduction of the length of hospital stay by 40%.
About the authors
A. S. Allakhverdyan
Moscow Regional Research and Clinical Institute
Author for correspondence.
Email: allakhverdyan@yandex.ru
Allakhverdyan Aleksandr Sergeevich – MD, PhD, Professor, Leading Research Fellow, Head of Research and Clinical Center on Video Endoscopic and Minimally Invasive Surgery; Chair of Oncology and Thoracic Surgery, Postgraduate Training Faculty Россия
V. S. Mazurin
Moscow Regional Research and Clinical Institute
Email: allakhverdyan@yandex.ru
Mazurin Valentin Sergeevich – MD, PhD, Professor, Head of Department of Thoracic Surgery, Head of Chair of Oncology and Thoracic Surgery, Postgraduate Training Faculty Россия
A. V. Frolov
Moscow Regional Research and Clinical Institute
Email: allakhverdyan@yandex.ru
Frolov Aleksey Vladimirovich – Junior Research Fellow, Department of Thoracic Surgery Россия
N. N. Anipchenko
Moscow Regional Research and Clinical Institute
Email: allakhverdyan@yandex.ru
Anipchenko Natal'ya Nikolaevna – Physician, Department of Anesthesiology Россия
References
- Черноусов АФ, Андрианов ВА, Гаджиев АН, Ручкин ДВ. Хирургическое лечение нервно-мышечных заболеваний пищевода. Анналы хирургии. 2001;(1):35–8.
- Оскретков ВИ, ред. Видеоэндоскопическая хирургия пищевода. Барнаул: Аз Бука; 2004. 159 с.
- Шептулин АА, Трухманов АС. Новое в диагностике и лечении гастроэзофагеальной рефлюксной болезни и ахалазии кардии. Клиническая медицина. 1998;(5):15–9.
- Persson J, Johnsson E, Kostic S, Lundell L, Smedh U. Treatment of achalasia with laparoscopic myotomy or pneumatic dilatation: long-term results of a prospective, randomized study. World J Surg. 2015;39(3):713–20. doi: 10.1007/s00268-014-2869-4.
- Crema E, Ribeiro LB, Terra JA Jr, Silva AA. Laparoscopic transhiatal subtotal esophagectomy for the treatment of advanced megaesophagus. Ann Thorac Surg. 2005;80(4):1196–201.
- Palanivelu C, Rangarajan M, Jategaonkar PA, Maheshkumaar GS, Vijay Anand N. Laparoscopic transhiatal esophagectomy for 'sigmoid' megaesophagus following failed cardiomyotomy: experience of 11 patients. Dig Dis Sci. 2008;53(6):1513–8.
- Черноусов АФ, Богопольский ПМ, Курбанов ФС. Хирургия пищевода: руководство для врачей. М.: Медицина; 2000. 352 с.
- Wong SK, Chan AC, Lee DW, To EW, Ng EK, Chung SC. Minimal invasive approach of gastric and esophageal mobilization in total pharyngolaryngoesophagectomy: total laparoscopic and hand-assisted laparoscopic technique. Surg Endosc. 2003;17(5):798–802.
- Schwenk W, Spies C, Müller JM. Fast Track in der operativen Medizin. Heidelberg: Springer; 2009. 786 p. (in Deutch).