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The Journal of Thoracic and Cardiovascular Surgery, Vol 97, 575-577, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Treatment of esophageal achalasia (cardiospasm) with diaphragmatic graft. Twenty-five years' experience

YX Yu and KD Yu
Department of Cardiothoracic Surgery, Fourth Hospital, Shenyang, People's Republic of China.

Long-term results are presented in 60 patients (4 to 50 years old) who underwent a diaphragmatic graft procedure for relief of cardiospasm (achalasia) from 1962 through 1987. The operative technique involves construction of a pedicle flap of diaphragm. The muscular defect on the lower segment of the esophagus and the transplanted diaphragmatic pedicle that is sutured to the defect must be the same size. Immediate operative results were good. Only one complication developed, a case of pneumonia that was cured. The patients were followed up from 11 months to 25 years. Two patients were lost to follow-up, 55 had excellent results, and three patients still had nausea and heartburn but were better than before the operation. This procedure has three advantages: (1) It prevents the development of fistulas and diverticula at the site of the esophageal muscular defect; (2) it effectively eliminates both restenosis resulting from scar tissue and reflux esophagitis; and (3) it allows the cardia to recover its normal function and the esophagus to return to normal size at the site of the operation.


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 J. Thorac. Cardiovasc. Surg.Home page
T. C. Mineo and V. Ambrogi
THE DIAPHRAGMATIC FLAP: A MULTIUSE MATERIAL IN THORACIC SURGERY
J. Thorac. Cardiovasc. Surg., December 1, 1999; 118(6): 1084 - 1089.
[Abstract] [Full Text] [PDF]


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