The Results of Surgical Treatment Esophageal Ahalasia


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Abstract

The purpose of the study Rating immediate and long-term results esophagoplasty in patients with achalasia of the esophagus. Material and methods The extirpation of esophagus was performed in 47 patients with ahalasia of the esophagus. In postoperative period all patients were examined in terms of 1 month to 10 years. Performed endoscopy of artificial esophagus, X-ray and EUS of artificial esophagus. Results and their discussion In 53.2 % of the cases in the first 6 months after surgery were observed in the form of the common symptoms of weakness, fatigue, and a significant reduction in physical activity , united us in asthenic syndrome . Dumping syndrome was diagnosed in 7 patients and arrested in 5 patiens. Pilorospasm diagnosed in 4 patients. Achieved 1-2 year balloon dilation of the pylorus with a good clinical effect. Anastomotic stenosis was diagnosed in 20 patients. Held from 1 to 5 courses bougienage and (or) the dilation of the anastomosis with a good clinical effect for 1 year after surgery. According to the endo ultrasound identified and described three types of blood supply to the graft and esofagogastroanastomosis: central ( trunk ) , loose and mixed . Noting the large number of anastomotic stenosis in the central type of blood supply. Conclusion Extirpation of the esophagus with achalasia stage IV disease is an effective surgical intervention. All patients in the postoperative period require clinical, endoscopic and radiological monitoring, allowing in the early stages to identify and address emerging disease states, without resorting to an "open" surgical procedures . Adverse prognostic factor for esophageal anastomotic stenosis scarring is main type of gastric blood flow of the graft. These patients require dynamic endoscopic observation within 1-3 months after surgery

About the authors

Novosibirsk State Medical University, 52 Krasnii Prospekt Str., Novosibirsk, 630091, Russian Federation
Novosibirsk State Regional Hospital, 130 Nemirovicha-Danchenko Str., Novosibirsk, 630087, Russian
Federation

Author for correspondence.
Email: chikinev@inbox.ru
MD, prof., head of department of hospital and child surgery Novosibirsk State medical university. Thoracic surgeon, of department of Thoracic surgery Novosibirsk regional clinical hospital Russian Federation

Novosibirsk State Medical University, 52 Krasnii Prospekt Str., Novosibirsk, 630091, Russian Federation
Novosibirsk State Regional Hospital, 130 Nemirovicha-Danchenko Str., Novosibirsk, 630087, Russian
Federation

Email: evgenyidrob@inbox.ru
MD, associate prof. of department of hospital and child surgery Novosibirsk State medical university. Thoracic surgeon, endoscopist of department of Thoracic surgery Novosibirsk regional clinical hospital. Russian Federation

Novosibirsk State Medical University, 52 Krasnii Prospekt Str., Novosibirsk, 630091, Russian Federation
Novosibirsk State Regional Hospital, 130 Nemirovicha-Danchenko Str., Novosibirsk, 630087, Russian
Federation

Email: ness-24@yandex.ru
– assistant of department of anesthesiology and critical care Novosibirsk State medical university, anesthesioligist of department of anesthesiology and critical care Novosibirsk regional clinical hospital Russian Federation

Novosibirsk State Medical University, 52 Krasnii Prospekt Str., Novosibirsk, 630091, Russian Federation

Email: vereschagin.evgeny@yandex.ru
- MD, prof., head of department of anesthesiology and critical care Novosibirsk State medical university; Russian Federation

Novosibirsk State Medical University, 52 Krasnii Prospekt Str., Novosibirsk, 630091, Russian Federation

Email: author@vestnik-surgery.com
graduate student of department of hospital and children’s surgery Novosibirsk state medical university Russian Federation

References

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