Laparoscopic cardioplasty to avoid esophageal resection in patient not responsive to Heller myotomy.
Some achalasia patients do not ameliorate dysphagia after Heller myotomy. If stenosis does not respond to endoscopic dilatations and persists after a second extended myotomy, an esophageal resection is considered unavoidable. This article describes an original technique of treating this type of persistent stenosis with an esophageal stricturoplasty. The procedure was completed under laparoscopy. The postoperative course was uneventful. Resolution of all preoperative symptoms was achieved at the first year follow-up. Control of gastroesophageal reflux was documented by 24-hour pH-impedance. If confirmed by further cases, laparoscopic esophageal stricturoplasty could become a valid option for a conservative treatment of these patients.
del Genio
Gianmattia
G
First Division of General and Gastrointestinal Surgery, Second University of Naples, Naples, Italy. gdg@doctor.com
del Genio
Alberto
A
Brusciano
Luigi
L
Russo
Gianluca
G
Pizza
Francesco
F
del Genio
Federica
F
Rossetti
Gianluca
G
D000328:Adult; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004931:Esophageal Achalasia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D012086:Reoperation