WAYS TO IMPROVE RESULTS OF ENDOSURGICAL TREATMENT OF ACHALASIA
https://doi.org/10.38181/2223-2427-2020-2-5-9
Abstract
Aim. To improve the method of Heller cardiomyotomy for best immediate and long-term results of treatment of esophageal achalasia.
Materials and methods. Analyzing the results of surgical treatment of 280 patients with esophageal achalasia who were treated in the Department of Surgical Diseases and New Technologies of the Bashkir State Medical University (Ufa) and the Department of Surgery and Stomach of the Republican Clinical Oncology Center (Kazan) for a period from 2000 to 2019. We conducted a cohort retrospective study in 2 groups (laparoscopic esophagocardiomyotomy according to Heller, supplemented by anterior modified hemifundoplication according to Dor (n = 74) and traditional laparoscopic interventions (n = 206).
Results. The authors have developed an original method of laparoscopic esophagocardiomyotomy, including the use of devices that facilitate the mobilization of cardia and the formation of fundoplication cuffs. Patients were examined by performing esophagogastroduodenoscopy, contrast X-ray scopy of the esophagus and stomach, esophagomanometry, pH-measurement in distal part of esophagus. Long-term results of up to 2 years were tracked. Surgically treated patients were tested by special application forms. Received results showed the restoration of quality of life in most of the subjects.
Conclusion The developed technique of laparoscopic esophagocardiomyotomy, including the use of intra-esophageal transillumination and a device for measuring the esophagus, prevents damage to the esophagus wall and postoperative complications associated with insufficient or excessive narrowing of the esophagus. Of the 74 patients, 66 (89.2 %) rated the result as excellent and good, 6 (8.1 %) as satisfactory, and 2 (2.7 %) as unsatisfactory.
About the Authors
O. V. Galimov
Bashkir State Medical University
Russian Federation
Russian Federation
Galimov Oleg Vladimorovich
3, Lenina str, Ufa, 450008, Republic of Bashkortostan
V. O. Khanov
Bashkir State Medical University
Russian Federation
Russian Federation
Khanov Vladislav Olegovich
3, Lenina str, Ufa, 450008, Republic of Bashkortostan
phone: +7 (347) 2721160
M. R. Bakirov
Bashkir State Medical University
Russian Federation
Russian Federation
Bakirov Marat Ravilevich
3, Lenina str, Ufa, 450008, Republic of Bashkortostan
R. R. Saifullin
Bashkir State Medical University
Russian Federation
Russian Federation
Saifullin Rustam Rashitovich
3, Lenina str, Ufa, 450008, Republic of Bashkortostan
D. O. Galimov
Bashkir State Medical University
Russian Federation
Russian Federation
Galimov Dmitrii Olegovich
3, Lenina str, Ufa, 450008, Republic of Bashkortostan
References
1. Allakhverdyan A.S. The choice of the method of laparoscopic fundoplication with compromised esophageal motility. Vestnik poslediplomnogo meditsinskogo obrazovaniya 2016; 2; 72-75. (In Russ.)
2. Chernousov A.F., Khorobrykh T.V., Vetshev F.P., Melent’ev A.A., Osminin S.V. Achalasia of the cardia and cardiospasm - modern principles of treatment. Annaly khirurgii 2012; 3; 5-10. (In Russ.)
3. Chikinev Yu.V., Drobyazgin E.A. Mediastinoscopy in the surgery of benign diseases of the esophagus and cardia. Vestnik khirurgii im. I.I. Grekova 2016; 5; 53-57. (In Russ.)
4. Oskretkov V.I., Balatsky D.V., Guryanov A.A. The functional state of the cardia after various methods of treatment of esophageal achalasia. Khirurg 2016; 3; 13-18. (In Russ.)
5. Anischenko V.V., Kovgan Yu.M., Nalbandyan A.G., Kim D.A., Platonov P.A. Esophagocardiofundoplasty as a method of treating cardiac achalasia. Voprosy rekonstruktivnoy i plasticheskoy khirurgii 2017; 1(60); 40-45. (In Russ.)
6. Galimov O.V., Khanov V.O., Ziangirov R.A., Saifullin R.R. Criteria for choosing a method for correcting hiatal hernias. Materialy XII s’yezda khirurgov Rossii, Rostov-na-Donu – 2015. Al’manakh instituta khirurgii im. A.V. Vishnevskogo 2015; 2; 211-212. (In Russ.)
7. Karpov O.E., Vetshev P.S., Vasiliev I.V., Maady A.S., Alekseev K.I., Osipov A.S. Endoscopic technologies in the diagnosis and treatment of cardiac achalasia. Vestnik Natsional’nogo mediko-khirurgicheskogo tsentra im. N.I. Pirogova 2016; (1); 11; 30-36. (In Russ.)
8. Akintoye E., Kumar N., Obaitan I. et al. Peroral endoscopic myotomy: a metaanalysis. Endoscopy 2016; E-pub ahead of print. http://dx.doi.org/10.1055/s-0042-114426
9. Ren Z., Zhong Y., Zhou Р. et al. Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases). Surg Endosc 2012; 26; 3267-3272.
10. Zhang W.G., Linghu E.Q., Chai N.L., Li H.K. Ling classification describes endoscopic progressive process of achalasia and successful peroral endoscopy myotomy prevents endoscopic progression of achalasia. World J Gastroenterol 2017; 23(18); 309-314. http://dx.doi.org/0.3748/wjg.v23.i18.3309
11. Rawlings A., Soper N., Oelschlager B. et al. Laparoscopic Dor versus Toupet Fundoplication following Heller Myotomy for Achalasia: Results of a Multicenter, Prospective Randomized-Controlled Trial. Surg Endosc 2012; Jan; 26(1); 18-26.
12. Yano F., Omura N., Tsuboi K., et al. Learning curve for laparoscopic Heller myotomy and Dor fundoplication for Achalasia. PLoS One 2017; 12(7); 1023-1026. http://dx.doi.org/10.1371/journal.pone.0180515
13. Galljamov E., Agapov M., Erin S., Galljamov E., Gololobov G., Lutsevich O., and Presnov K. Experience of laparoscopic refundoplication. Surgical Endoscopy (2018), 51–52. https://doi.org/10.1007/s00464018-6179-z
14. Galliamov E.A., Agapov M.A., Lucevich O.E., Kubishkin V.A., Erin S.A., Presnov K.S., Busyrev Y.B., Kakotkin V.V., Torosyan O.G. Laparoscopic correction of recurrence of gastroesophageal reflux disease and hernia of the esophageal aperture of the diaphragm. Surgical practice. 2019; (3):33-40. (In Russ.) https://doi.org/10.38181/issn2223-2427.2019.3.33-40
Review
For citations:
Galimov O.V., Khanov V.O., Bakirov M.R., Saifullin R.R., Galimov D.O. WAYS TO IMPROVE RESULTS OF ENDOSURGICAL TREATMENT OF ACHALASIA. Surgical practice (Russia). 2020;(2):5-9. (In Russ.) https://doi.org/10.38181/2223-2427-2020-2-5-9
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