Long-term results of laparoscopic treatment for oesophageal achalasia with epiphrenic diverticulum are reported in a 75-year-old woman presenting with a 10-year history of dysphagia, regurgitation, cough, and a 10-kg weight loss. Preoperative barium swallow showed a dilated sigmoid oesophagus with a 6-cm enlarging epiphrenic diverticulum. Endoscopic biopsies were negative for cancer and oesophageal manometry showed no peristalsis. Laparoscopic diverticulectomy and a 7-cm distal oesophageal myotomy with Dor fundoplication were performed. The postoperative course wasuneventful and the patient was discharged home 5 days after the operation, symptom-free, and tolerated a soft diet. Six months postoperatively she had no symptoms, ate without restrictions, had gained 8 kg, and showed a normal-sized oesophagus with regular emptying on barium swallow. At the 6-year follow-up, the patient was free of symptoms and had gained 19 kg of weight. Specifi cally, she had no dysphagia, regurgitation, heartburn or cough; a new barium swallow showed a normalsized oesophagus with tertiary contractions and a 2-cm epiphrenic diverticulum.
OESOPHAGEAL ACHALASIA WITH EPIPHRENIC CIVERTICULUM WITH LAPAROSCOPIC APPROACH: A 6-YEAR FOLLOW-UP
FEO, Carlo;LIBONI, Alberto
2006
Abstract
Long-term results of laparoscopic treatment for oesophageal achalasia with epiphrenic diverticulum are reported in a 75-year-old woman presenting with a 10-year history of dysphagia, regurgitation, cough, and a 10-kg weight loss. Preoperative barium swallow showed a dilated sigmoid oesophagus with a 6-cm enlarging epiphrenic diverticulum. Endoscopic biopsies were negative for cancer and oesophageal manometry showed no peristalsis. Laparoscopic diverticulectomy and a 7-cm distal oesophageal myotomy with Dor fundoplication were performed. The postoperative course wasuneventful and the patient was discharged home 5 days after the operation, symptom-free, and tolerated a soft diet. Six months postoperatively she had no symptoms, ate without restrictions, had gained 8 kg, and showed a normal-sized oesophagus with regular emptying on barium swallow. At the 6-year follow-up, the patient was free of symptoms and had gained 19 kg of weight. Specifi cally, she had no dysphagia, regurgitation, heartburn or cough; a new barium swallow showed a normalsized oesophagus with tertiary contractions and a 2-cm epiphrenic diverticulum.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
