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01-02-2011 | 2010 SSAT Quick Shot Presentation

Improvement of Respiratory Symptoms Following Heller Myotomy for Achalasia

Authors: Saurabh Khandelwal, Rebecca Petersen, Roger Tatum, Huseyin Sinan, Daniel Aaronson, Fernando Mier, Ana V. Martin, Carlos A. Pellegrini, Brant K. Oelschlager

Published in: Journal of Gastrointestinal Surgery | Issue 2/2011

Abstract

Introduction

Although patients with achalasia complain mainly of dysphagia, we have observed that they also have a high rate of respiratory problems. We hypothesized that the latter may be due to poor esophageal clearance leading to aspiration. This study examines the effect of Heller myotomy on these symptoms.

Methods

We studied the course of 111 patients with achalasia who underwent Heller myotomy between 1994 and 2008 and who agreed to participate in this study. All patients completed a questionnaire postoperatively assessing the preoperative and postoperative prevalence and severity of symptoms using visual analog scales. Patients were divided into two groups: one that included all those with respiratory symptoms (dyspnea, hoarseness, cough, wheezing, sore throat, and/or a history of asthma or pneumonia) prior to myotomy and one that included those without those symptoms.

Results

All patients presented with dysphagia as their primary complaint, and 63 (57%) reported respiratory symptoms or disease prior to surgery. There were no significant differences in preoperative characteristics between those with and without respiratory manifestations. After a median follow-up of 71 months (range 9–186 months), 55 (87%) patients reported durable improvement of dysphagia. The frequency and severity of all respiratory symptoms decreased significantly. Twenty-four of the 29 patients (82%) who reported a history of pneumonia prior to surgery did not experience recurrent episodes after Heller myotomy.

Conclusions

A Heller myotomy is effective in improving esophageal emptying in patients with achalasia. This results in sustained improvement of dysphagia and associated respiratory symptoms/diseases. This suggests that respiratory symptoms/diseases in these patients are likely caused by esophageal retention of food and secretions, and then aspiration.

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Title: Improvement of Respiratory Symptoms Following Heller Myotomy for Achalasia
Authors: Saurabh Khandelwal
Rebecca Petersen
Roger Tatum
Huseyin Sinan
Daniel Aaronson
Fernando Mier
Ana V. Martin
Carlos A. Pellegrini
Brant K. Oelschlager
Publication date: 01-02-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 2/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-010-1397-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Improvement of Respiratory Symptoms Following Heller Myotomy for Achalasia

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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