title: Long myotomy of the esophagus and gastric cardia with a complete fundic patch procedure for diffuse esophageal spasm.
abstract: Under the hypothesis that the surgical management of diffuse esophageal spasm requires the elimination or reduction of episodes of dysphagia and chest pain and prevention of postoperative gastroesophageal reflux, long esophageal myotomy and fundoplication had been performed. However, there have been some cases with unsatisfactory results. We describe herein a new surgical procedure of long myotomy of the esophagus and gastric cardia with a complete fundic patch operation for the patient with diffuse esophageal spasm. The advantages of this procedure are to preserve the separation of each myotomized edge and to reinforce the wall of the surface of the myotomized mucosa in order to avoid the postoperative problems. Postoperative course of the patient with this procedure was satisfactory.
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, Maebashi, Gunma, Japan. hkuwano@med.gunma-u.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Norihiro
authors.initials: N
authors.lastname: Masuda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Motoyasu
authors.initials: M
authors.lastname: Kusano
mesh_terms: D003131:Combined Modality Therapy; D015155:Esophageal Spasm, Diffuse / Q000175:diagnosis* / Q000601:surgery*; D004943:Esophagogastric Junction / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D004947:Esophagus / Q000601:surgery; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods; D005748:Gastric Fundus / Q000601:surgery*; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D013524:Surgical Flaps; D016896:Treatment Outcome