Tosato F, Passaro U, Scocchera F, Vasapollo L, Giordani D, Paolini A
Servizio Speciale di Chirurgia Esofagea, Policlinico Umberto I, Roma.
Minerva Chir. 1998 Mar;53(3):203-11.
Both surgery and dilatation are useful for the treatment of cardial achalasia. The authors make a wide review of the literature with particular attention to reports comparing results of these procedures. This review evidences that surgery gives better results than dilatations (84.4% of good results with surgery against 71.4% with repeated dilatations) and is certainly more stable over the years. Mini-invasive surgery points out even more strongly that surgery is nowadays to be preferred. Laparoscopy makes it possible to avoid postoperative pain, to discharge the patient in a couple of days and finally to eliminate surgical scars. Complications, even more frequent after surgery (5.5% against 2.1% of dilatation) are still acceptable in number and not heavy in quality.
手术和扩张术对贲门失弛缓症的治疗均有效。作者对文献进行了广泛综述,尤其关注比较这些治疗方法效果的报告。该综述表明,手术的效果优于扩张术(手术的良好效果率为84.4%,而反复扩张术为71.4%),且多年来肯定更稳定。微创手术更有力地表明,如今手术更值得首选。腹腔镜检查能够避免术后疼痛,使患者在数天内即可出院,并最终消除手术疤痕。手术的并发症虽然比扩张术更常见(分别为5.5%和2.1%),但其数量仍可接受,且严重程度不高。