OBJECTIVE: To assess the long-term results and health-related quality of life in patients undergoing surgery for oesophageal achalasia. METHODS: Thirty-nine patients with achalasia (25 males, mean age 42+/-13 years) underwent open-Heller myotomy and Dor fundoplication by the same surgeon. Long-term results were assessed by imaging, endoscopy, manometry, pH-metry, and Short Form 36 and Nottingham Health Profile questionnaires whenever applicable. Six patients were at radiological stage I, 20 were at stage II, 2 at stage III and 11 at stage IV. Dysphagia and regurgitation were scored according to the four-grade classification (1=no symptoms; 4=persistent symptoms). Pulmonary symptoms were present in six patients. Lower oesophageal pressure was 30+/-34 mmHg. Six patients had undergone previous pneumatodilation. RESULTS: No procedure related mortality was recorded. Mean follow-up was 107+/-30 months (54-177). Preoperative to 5-year postoperative mean decrement in lower oesophageal sphincter pressure was 12.3+/-8.3 mmHg (P < 0.001) in oesophageal width was 11.5+/-7.1 mm (P < 0.001) in dysphagia 1.8+/-0.8 (P < 0.001) and regurgitation 1.4+/-0.7 (P < 0.001) Four patients presented relapse dysphagia and two of those were re-operated upon. Three patients developed acid reflux, which was satisfactorily treated with proton-pump inhibitors. Preoperative to 4-year postoperative quality of life scores were available for 20 patients. Questionnaires showed a significant improvement (P < 0.001) especially in all psychosocial domains, which were correlated with postoperative dysphagia score and lower oesophageal sphincter pressure. CONCLUSION: Heller myotomy and Dor fundoplication is a safe and effective procedure that improves symptoms, functional status and especially psychosocial aspect of quality of life in the long term in oesophageal achalasia

Mineo, T.c., Ambrogi, V. (2004). Long-term results and quality of life after surgery for oesophageal achalasia: one surgeon's experience. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 25(6), 1089-1096 [10.1016/j.ejcts.2004.01.043].

Long-term results and quality of life after surgery for oesophageal achalasia: one surgeon's experience

MINEO, TOMMASO CLAUDIO;AMBROGI, VINCENZO
2004-06-01

Abstract

OBJECTIVE: To assess the long-term results and health-related quality of life in patients undergoing surgery for oesophageal achalasia. METHODS: Thirty-nine patients with achalasia (25 males, mean age 42+/-13 years) underwent open-Heller myotomy and Dor fundoplication by the same surgeon. Long-term results were assessed by imaging, endoscopy, manometry, pH-metry, and Short Form 36 and Nottingham Health Profile questionnaires whenever applicable. Six patients were at radiological stage I, 20 were at stage II, 2 at stage III and 11 at stage IV. Dysphagia and regurgitation were scored according to the four-grade classification (1=no symptoms; 4=persistent symptoms). Pulmonary symptoms were present in six patients. Lower oesophageal pressure was 30+/-34 mmHg. Six patients had undergone previous pneumatodilation. RESULTS: No procedure related mortality was recorded. Mean follow-up was 107+/-30 months (54-177). Preoperative to 5-year postoperative mean decrement in lower oesophageal sphincter pressure was 12.3+/-8.3 mmHg (P < 0.001) in oesophageal width was 11.5+/-7.1 mm (P < 0.001) in dysphagia 1.8+/-0.8 (P < 0.001) and regurgitation 1.4+/-0.7 (P < 0.001) Four patients presented relapse dysphagia and two of those were re-operated upon. Three patients developed acid reflux, which was satisfactorily treated with proton-pump inhibitors. Preoperative to 4-year postoperative quality of life scores were available for 20 patients. Questionnaires showed a significant improvement (P < 0.001) especially in all psychosocial domains, which were correlated with postoperative dysphagia score and lower oesophageal sphincter pressure. CONCLUSION: Heller myotomy and Dor fundoplication is a safe and effective procedure that improves symptoms, functional status and especially psychosocial aspect of quality of life in the long term in oesophageal achalasia
giu-2004
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/21 - CHIRURGIA TORACICA
English
Con Impact Factor ISI
Severity of Illness Index; Disease-Free Survival; Humans; Quality of Life; Deglutition Disorders; Fundoplication; Adult; Treatment Outcome; Esophagogastric Junction; Esophageal Achalasia; Follow-Up Studies; Middle Aged; Female; Male
Mineo, T.c., Ambrogi, V. (2004). Long-term results and quality of life after surgery for oesophageal achalasia: one surgeon's experience. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 25(6), 1089-1096 [10.1016/j.ejcts.2004.01.043].
Mineo, Tc; Ambrogi, V
Articolo su rivista
File in questo prodotto:
File Dimensione Formato  
4.pdf

accesso aperto

Dimensione 205.38 kB
Formato Adobe PDF
205.38 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/35415
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 33
  • ???jsp.display-item.citation.isi??? 26
social impact