title: Outcomes of esophagectomy for esophageal achalasia in the United States.
abstract: BACKGROUND
  While the outcomes after Heller myotomy have been extensively reported, little is known about patients with esophageal achalasia who are treated with esophagectomy.
  
  
  METHODS
  This was a retrospective analysis using the Nationwide Inpatient Sample over an 11-year period (2000-2010). Patients admitted with a primary diagnosis of achalasia who underwent esophagectomy (group 1) were compared to patients with esophageal cancer who underwent esophagectomy (group 2) during the same time period. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay, postoperative complications, and total hospital charges. A propensity-matched analysis was conducted comparing the same outcomes between group 1 and well-matched controls in group 2.
  
  
  RESULTS
  Nine hundred sixty-three patients with achalasia and 18,003 patients with esophageal cancer underwent esophagectomy. The propensity matched analysis showed a trend toward a higher mortality in group 2 (7.8 vs. 2.9 %, p = 0.08). Postoperative length of stay and complications were similar in both groups. Total hospital charges were higher for the achalasia group ($115,087 vs. $99, 654.2, p = 0.006).
  
  
  CONCLUSIONS
  This is the largest study to date examining outcomes after esophagectomy in patients with achalasia. Based on our findings, esophagectomy can be considered a safe option, and surgeons should not be hindered by a perceived notion of prohibitive operative risk in this patient population.
authors: Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University, 600 N Wolfe Street, Blalock 240, Baltimore, MD, 21287, USA, dmolena2@jhmi.edu.
authors: Daniela
authors: D
authors: Molena
authors: Benedetto
authors: B
authors: Mungo
authors: Miloslawa
authors: M
authors: Stem
authors: Richard L
authors: RL
authors: Feinberg
authors: Anne O
authors: AO
authors: Lidor
mesh_terms: D000367:Age Factors; D000368:Aged; D002561:Cerebrovascular Disorders / Q000401:mortality; D015897:Comorbidity; D004931:Esophageal Achalasia / Q000191:economics / Q000401:mortality / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000191:economics / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000191:economics / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000401:mortality; D017722:Hospital Charges / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007674:Kidney Diseases / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D044342:Malnutrition / Q000401:mortality; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
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