title: Results of surgical treatment of esophageal achalasia. Multicenter retrospective study of 1,856 cases. GEEMO (Groupe Européen Etude Maladies Oesophagéennes) Multicentric Retrospective Study.
abstract: A retrospective analysis of 1,856 patients treated by esophageal achalasia in 23 different surgical departments from seven countries is reported. The predominant symptom was dysphagia (100%), pain, vomiting and weight loss (76.1%). The most useful diagnostic methods were: barium meal (85%), manometry (100%), endoscopy (100%) and 99mTc (100%). Conservative treatment (5.45%) was useful in 5.8% only. Dilatation (16.9%) produced amelioration in 65.9%. Thoracotomy was used in 20.9% and middle line laparotomy in 79.2%. Heller esophagomyotomy was performed in 99.52% associated with anterior fundoplasty in 79.8% and postero-lateral (Mark IV) in 9.75%. Most of the patients were controlled through barium meal, esophagoscopy, esophageal manometry, pHmetry and 99mTc ingestion. Good results after Heller's myotomy with anterior fundoplication were 81.7% and poor 7.2%. Recurrence of achalasia was present in 184 patients. A new esophagomyotomy was performed on 58.6% and distal esophageal resection in 62 (35.3%). In total, 988 patients were reviewed once a year. Absence of gastroesophageal reflux was shown in 73.9% of the explored patients.
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo C, Hospital Primero de Octubre, Universidad Complutense, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Moreno González
authors.forename: A
authors.initials: A
authors.lastname: Garcia Alvarez
authors.forename: I
authors.initials: I
authors.lastname: Landa Garcia
authors.forename: M
authors.initials: M
authors.lastname: Gómez Gutierrez
authors.forename: P
authors.initials: P
authors.lastname: Rico Selas
authors.forename: I
authors.initials: I
authors.lastname: Garcia Garcia
authors.forename: J M
authors.initials: JM
authors.lastname: Jover Navalón
authors.forename: J
authors.initials: J
authors.lastname: Arias Diaz
mesh_terms: D000328:Adult; D004931:Esophageal Achalasia / Q000175:diagnosis / Q000601:surgery*; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies