title: End-stage achalasia.
abstract: Despite symptom improvement offered to achalasia patients by either pneumatic dilation or surgical myotomy, 10% to 15% of those so treated will present progressive deterioration of their esophageal function and up to 5% may eventually require an esophagectomy. The natural evolution of achalasia to its end stage as well as the timing of esophagectomy in these patients form the basis of this review. The optimal reconstruction for the decompensated resected esophagus will also be explored: gastric interposition, colon interposition, and jejunal interposition all have their respective advantages and disadvantages. Their use is examined in the exclusive context of resection for achalasia.
authors.affiliation: Department of Surgery, Université de Montréal, Division of Thoracic Surgery, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada. andre.duranceau@umontreal.ca
authors.forename: A
authors.initials: A
authors.lastname: Duranceau
authors.forename: M
authors.initials: M
authors.lastname: Liberman
authors.forename: J
authors.initials: J
authors.lastname: Martin
authors.forename: P
authors.initials: P
authors.lastname: Ferraro
mesh_terms: D000713:Anastomosis, Roux-en-Y; D003106:Colon / Q000637:transplantation; D018450:Disease Progression; D004931:Esophageal Achalasia / Q000503:physiopathology / Q000601:surgery*; D016629:Esophagectomy; D004944:Esophagoplasty; D004947:Esophagus / Q000503:physiopathology / Q000601:surgery*; D015390:Gastric Bypass; D006801:Humans; D007583:Jejunum / Q000637:transplantation; D013270:Stomach / Q000637:transplantation; D017211:Treatment Failure