Department of Surgery, Fuji City General Hospital, 50, Takashima-cho, Fuji, Shizuoka, 416-0951, Japan.
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Langenbecks Arch Surg. 2021 Dec;406(8):2679-2686. doi: 10.1007/s00423-021-02270-1. Epub 2021 Jul 20.
It is common knowledge that esophageal achalasia patients have a high risk of developing esophageal carcinoma. The present study assessed the characteristics of esophageal carcinoma patients following laparoscopic Heller-Dor surgery (LHD) for esophageal achalasia.
Among 622 cases which were esophageal achalasia patients and underwent LHD as the primary surgery, we compared the patient background, pathophysiology, symptoms, and surgical outcomes according to whether or not esophageal carcinoma occurred following surgery.
Six cases (0.96%) of postoperative esophageal carcinoma were confirmed. The characteristics of the cases in which esophageal carcinoma occurred were older age, longer disease duration (p = 0.0362 and 0.0028, respectively), decreased sphincter pressure of the lower esophagus, a high rate of sigmoid esophagus, and a long esophagus lateral diameter (p = 0.0214, 0.001, and 0.0416, respectively). Moreover, no differences in surgical outcomes were confirmed and there were no differences in symptoms from before and following surgery.
The characteristics of esophageal carcinoma patients with achalasia following laparoscopic myotomy were an older age, longer disease duration, and greater progression of disease pathophysiology.
众所周知，食管失弛缓症患者发生食管癌的风险较高。本研究评估了腹腔镜 Heller-Dor 手术（LHD）治疗食管失弛缓症后食管癌患者的特征。
在 622 例接受 LHD 作为原发性手术的食管失弛缓症患者中，我们根据手术后是否发生食管癌比较了患者背景、病理生理学、症状和手术结果。
术后证实 6 例（0.96%）发生食管癌。发生食管癌的病例特征为年龄较大，疾病持续时间较长（p=0.0362 和 0.0028，分别），下食管括约肌压力降低，乙状结肠食管率高，食管侧径较长（p=0.0214、0.001 和 0.0416，分别）。此外，手术结果无差异，且手术前后症状无差异。
食管失弛缓症患者行腹腔镜肌切开术后发生食管癌的特征为年龄较大、疾病持续时间较长、疾病病理生理学进展更大。
