title: Results of short- and long-segment cardioesophageal myotomy for achalasia.
abstract: OBJECTIVE
  We report the results of a short- and long-segment cardiomyotomy for relief of the symptoms of achalasia.
  
  
  METHODS
  From 1997 to 2009, 41 patients (22 men, 19 women) with achalasia underwent cardiomyotomy. Patients were divided into 2 groups [short-segment group (SSG) and long-segment group (LSG)]. SSG include 22 patients with laparotomy and 8-cm short-segment myotomy and Dor fundoplication. LSG includes 19 patients with thoracotomy and 12-cm long-segment myotomy and Belsey partial fundoplication. results: Median follow up was 48 months (range: 12-70 months). Postoperative dysphagia improved in 20 patients in SSG and in 17 patients in LSG (P < 0.001). Slow emptying sensation improved in 19 patients in SSG and in 16 patients in LSG postoperatively (P < 0.001). Heartburn was present in 2 patients in SSG and 3 patients in LSG postoperatively (P = 0.179). Radiologically, barium stasis decreased significantly from 88% to 25% in SSG and from 85% to 30% in LSG. The lower esophageal sphincter (LES) gradient decreased from 32 to 10 mmHg in SSG and from 34 to 14 mmHg in LSG (P < 0.001).
  
  
  CONCLUSIONS
  Short-segment cardiomyotomy reduces the LES gradient and relieves obstructive symptoms.
authors: Respiratory Diseases and TB Research Center of Guilan University of Medical Sciences, Razi Hospital, Rasht, Iran. maghajanzadeh2003@yahoo.com
authors: Manouchehr
authors: M
authors: Aghajanzadeh
authors: Anoush D
authors: AD
authors: Moghadam
authors: Hosein
authors: H
authors: Hemmati
authors: Gilda
authors: G
authors: Aghajanzadeh
authors: Sara
authors: S
authors: Massahnia
mesh_terms: D000328:Adult; D000368:Aged; D002299:Cardia / Q000601:surgery*; D016145:Endoscopy, Digestive System; D004931:Esophageal Achalasia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D007813:Laparotomy; D008297:Male; D008365:Manometry; D008875:Middle Aged; D013908:Thoracotomy; D016896:Treatment Outcome; D055815:Young Adult