Department of General and Abdominal Surgery, Johannes Gutenberg-University of Mainz, Mainz, Germany.
J Gastrointest Surg. 2010 Feb;14 Suppl 1:S46-57. doi: 10.1007/s11605-009-1018-0. Epub 2009 Oct 24.
Heller myotomy leads to good-excellent long-term results in 90% of patients with achalasia and thereby has evolved to the "first-line" therapy. Failure of surgical treatment, however, remains an urgent problem which has been discussed controversially recently.
A systematic review of the literature was performed to analyze the long-term results of failures after Heller's operation with emphasis on treatment by remedial myotomy.
Other reinterventions and their causes after failure of surgical treatment in patients with achalasia are discussed.
Heller 肌切开术在 90%的贲门失弛缓症患者中可取得良好至极好的长期疗效,因此已成为“一线”治疗方法。然而,手术治疗失败仍然是一个紧迫的问题,最近对此存在争议。
对文献进行系统回顾,分析 Heller 手术后失败的长期结果,并重点分析补救性肌切开术的治疗效果。
讨论了贲门失弛缓症患者手术后治疗失败的其他再干预措施及其原因。