Respiratory Diseases and TB Research Center of Guilan University of Medical Sciences, Razi Hospital, Rasht, Iran.
Saudi J Gastroenterol. 2012 Jul-Aug;18(4):237-40. doi: 10.4103/1319-3767.98426.
BACKGROUND/AIM: We report the results of a short- and long-segment cardiomyotomy for relief of the symptoms of achalasia.
From 1997 to 2009, 41 patients (22 men, 19 women) with achalasia underwent cardiomyotomy. Patients were divided into 2 groups [short-segment group (SSG) and long-segment group (LSG)]. SSG include 22 patients with laparotomy and 8-cm short-segment myotomy and Dor fundoplication. LSG includes 19 patients with thoracotomy and 12-cm long-segment myotomy and Belsey partial fundoplication. results: Median follow up was 48 months (range: 12-70 months). Postoperative dysphagia improved in 20 patients in SSG and in 17 patients in LSG (P < 0.001). Slow emptying sensation improved in 19 patients in SSG and in 16 patients in LSG postoperatively (P < 0.001). Heartburn was present in 2 patients in SSG and 3 patients in LSG postoperatively (P = 0.179). Radiologically, barium stasis decreased significantly from 88% to 25% in SSG and from 85% to 30% in LSG. The lower esophageal sphincter (LES) gradient decreased from 32 to 10 mmHg in SSG and from 34 to 14 mmHg in LSG (P < 0.001).
Short-segment cardiomyotomy reduces the LES gradient and relieves obstructive symptoms.
背景/目的：我们报告了短节段和长节段心肌切开术缓解贲门失弛缓症症状的结果。
1997 年至 2009 年，41 例贲门失弛缓症患者（22 例男性，19 例女性）接受了心肌切开术。患者分为 2 组[短节段组（SSG）和长节段组（LSG）]。SSG 包括 22 例剖腹短节段 8cm 切开和 Dor 胃底折叠术。LSG 包括 19 例剖胸长节段 12cm 切开和 Belsey 部分胃底折叠术。结果：中位随访时间为 48 个月（范围：12-70 个月）。术后吞咽困难在 SSG 中 20 例和 LSG 中 17 例患者得到改善（P <0.001）。SSG 中 19 例和 LSG 中 16 例患者术后排空缓慢的感觉得到改善（P <0.001）。SSG 中有 2 例和 LSG 中有 3 例患者术后有烧心（P = 0.179）。放射学上，SSG 中钡剂停滞从 88%显著减少至 25%，LSG 中从 85%减少至 30%。LSG 中食管下括约肌（LES）梯度从 32mmHg 降至 10mmHg，LSG 中从 34mmHg 降至 14mmHg（P <0.001）。
短节段心肌切开术降低 LES 梯度并缓解梗阻症状。
