Result of surgical treatment of severe achalasia of the cardia (clinical observation).

Abstract

Тo evaluate the results of resection of the abdominal esophagus with the application of a circular hardware esophagogastroanastomosis in the surgical procedure for severe cardiac achalasia. A clinical observation of 71-year-old patients with stage IV achalasia cardia (according to B.V. Petrovsky) is presented. She was admitted for surgical treatment to the surgical department of the Amur Regional Clinical Hospital. Complaints of dysphagia, regurgitation of food eaten, chest pain, body weight loss of 20 kg. History of the disease for 22 years. Contrast fluoroscopy of the esophagus: the esophagus is sharply dilated in the middle and lower third up to 6 cm, the distal part of the esophagus is narrowed, evacuation of contrast into the stomach after 35 minutes. Esophagoscopy: signs of esophagitis, the cardia is not passable for an endoscope with a diameter of 1 cm. An operation was performed: resection of the abdominal esophagus with circular hardware esophagogastroanastomosis. Smooth early and long-term (after 6 months) postoperative period. There are no signs of dysphagia. Body weight gain over 6 months was 9 kg. With fluoroscopy and endoscopy of the esophagus six months later: the esophagus has shortened in length and changed, after the onset of contrast in the stomach without delay. The esophagus is freely accessible to the endoscope throughout Conclusion. This case led to a positive result of resection of the esophagus with esophagogastroanastomosis as a result of severe achalasia cardia stage IV (according to B.V. Petrovsky)