Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/77326
Type: Artigo de periódico
Title: Treatment of achalasia: lessons learned with Chagas' disease
Author: Herbella, FAM
Aquino, JLB
Stefani-Nakano, S
Artifon, ELA
Sakai, P
Crema, E
Andreollo, NA
Lopes, LR
Pochini, CD
Corsi, PR
Gagliardi, D
Del Grande, JC
Abstract: Chagas' disease (CD) is highly prevalent in South America. Brazilian surgeons and gastroenterologists gained valuable experience in the treatment of CD esophagopathy (chagasic achalasia) due to the high number of cases treated. The authors reviewed the lessons learned with the treatment of achalasia by different centers experienced in the treatment of Chagas' disease. Preoperative evaluation, endoscopic treatment (forceful dilatation and botulinum toxin injection), Heller's myotomy, esophagectomy, conservative techniques other than myotomy, and reoperations are discussed in the light of personal experiences and review of International and Brazilian literature. Aspects not frequently adopted by North American and European surgeons are emphasized. The review shows that nonadvanced achalasia is frequently treated by Heller's myotomy. Endoscopic treatment is reserved to limited cases. Treatment for end-stage achalasia is not unanimous. Esophagectomy was a popular treatment in advanced disease; however, the morbidity/mortality associated to the procedure made some authors seek different alternatives, such as Heller's myotomy and cardioplasties. Minimally invasive approach to esophageal resection may change this concept, although few centers perform the procedure routinely.
Subject: achalasia
Chagas' disease
esophagus
surgery
Country: EUA
Editor: Wiley-blackwell
Rights: fechado
Identifier DOI: 10.1111/j.1442-2050.2008.00811.x
Date Issue: 2008
Appears in Collections:Artigos e Materiais de Revistas Científicas - Unicamp

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