Bonavina Luigi, Bona Davide, Saino Greta, Clemente Claudio
Department of Medical and Surgical Sciences, Surgical Unit, I.R.C.C.S. Policlinico San Donato, University of Milan School of Medicine, Milan, Italy.
Langenbecks Arch Surg. 2007 Sep;392(5):653-6. doi: 10.1007/s00423-007-0191-4. Epub 2007 May 26.
Benign esophageal pseudoachalasia is a rare condition.
We report the case of a 70-year-old man who complained of severe dysphagia after laparoscopic Nissen fundoplication and crural mesh repair performed for long-standing gastroesophageal reflux disease. Severe dysphagia and nocturnal aspiration developed soon after the operation. A marked dilatation of the esophageal body and a manometric pattern resembling achalasia was documented.
Endoscopic balloon dilatation was ineffective. Five months after the initial operation, the patient underwent revisional laparoscopic surgery that consisted of Nissen's wrap takedown, enlargement of the hiatus with partial resection of the mesh, Heller myotomy, and Dor fundoplication. After a 2-year follow-up, the patient is doing well and is free of symptoms.
良性食管假性贲门失弛缓症是一种罕见的病症。
我们报告了一例70岁男性病例，该患者因长期胃食管反流病接受腹腔镜下Nissen胃底折叠术和膈肌脚补片修补术后出现严重吞咽困难。术后不久即出现严重吞咽困难和夜间误吸。记录显示食管体部明显扩张，测压模式类似贲门失弛缓症。
内镜下球囊扩张无效。初次手术后五个月，患者接受了翻修性腹腔镜手术，包括拆除Nissen胃底折叠术、部分切除补片扩大裂孔、Heller肌切开术和Dor胃底折叠术。经过两年的随访，患者情况良好，无症状。
