OBJECTIVES: To verify some possible factors, which would be associated with better or worse results for surgical treatment of megaesophagus. METHODS: There were 417 patients operated on for megaesophagus, but only 390 medical charts were analyzed between 1989 and 2005. The presence of intraoperative and postoperative complications and the maintenance of severe dysphagia complaints were evaluated in a directed questionnaire, studying association with: the surgical approach chosen, megaesophagus degree, etiology and presence of other digestive alterations. RESULTS: There were 360 cardiomiotomies, 20 esophagectomies and 11 mucosectomies. The results indicate that the cardiomiotomy is the safest surgery and the esophagectomy has more complications. The degree of megaesophagus is directed related with the results; more advanced megaesophagus has the worse results. The presence of digestive alterations has also a direct influence with worse results. CONCLUSION: The most important factor considering the results is the surgery chosen, and the best one were seen with cardiomiotomy. The degree of megaesophagus has also influenced the results. The etiology suggests better results with Chagas disease patients, maybe for the chronic course of this disease. The presence of digestive alteration is a factor which causes worse results, especially if associated with gastritis, esophagitis, megacolon and others.
OBJECTIVES: To verify some possible factors, which would be associated with better or worse results for surgical treatment of megaesophagus. METHODS: There were 417 patients operated on for megaesophagus, but only 390 medical charts were analyzed between 1989 and 2005. The presence of intraoperative and postoperative complications and the maintenance of severe dysphagia complaints were evaluated in a directed questionnaire, studying association with: the surgical approach chosen, megaesophagus degree, etiology and presence of other digestive alterations. RESULTS: There were 360 cardiomiotomies, 20 esophagectomies and 11 mucosectomies. The results indicate that the cardiomiotomy is the safest surgery and the esophagectomy has more complications. The degree of megaesophagus is directed related with the results; more advanced megaesophagus has the worse results. The presence of digestive alterations has also a direct influence with worse results. CONCLUSION: The most important factor considering the results is the surgery chosen, and the best one were seen with cardiomiotomy. The degree of megaesophagus has also influenced the results. The etiology suggests better results with Chagas diseasepatients, maybe for the chronic course of this disease. The presence of digestive alteration is a factor which causes worse results, especially if associated with gastritis, esophagitis, megacolon and others.
Authors: Gustavo Carvalho de Oliveira; Rodrigo Lima Bastos da Rocha; João de Souza Coelho-Neto; Valdir Terciotti-Junior; Luiz Roberto Lopes; Nelson Adami Andreollo Journal: Arq Bras Cir Dig Date: 2015