Our Achalasia Surgery Experiences with the Achalasia Surgery Review

Yıl 2020, Cilt: 47 Sayı: 1, 10 - 15, 17.03.2020

Tolga Kalayci Ümithaluk Iliklerden

https://doi.org/10.5798/dicletip.705538

Öz

Objective: Achalasia means disorder and dysfunction of Lower Esophageal Sphincter. Achalasia treatment was two types: non-surgical treatments and surgical treatments. Heller myotomy is the best surgical method of achalasia. In our study, we want to present our achalasia surgical experiences and the post-operative follow-up status of the patients for contribution to the literature.
Methods: After getting permission from ethics committee of our university, we collected data from patients who operated for achalasia between 2011 and 2019 retrospectively in Department of General Surgery, Van YuzuncuYil University Faculty of Medicine. Age and gender status, diagnosis process, presence of additional esophageal disease in the distal esophagus, surgical type, length of myotomy, presence of esophageal mucosal repair, duration of hospital stay and postoperative follow-up status of the patients were evaluated.
Findings: In our study, there were 11 patients who underwent achalasia surgery. The mean age of patients was 31.6 (19-50) years. 63.63% (n = 7) of all cases were female and 36.37% (n = 4) were male. Apart from one case (case with hiatal hernia association) other cases were performed laparotomically. The mean myotomy length was calculated as 9.09 (8-15) cm. The mean duration of hospital stay was 5.18 (3-7) days. Among the patients only one patient had difficulty in swallowing in the first month control. But it was observed that the same patient did not have difficulty in swallowing in the third month control.
Discussion: In our study, considering both our post-operative complication status and the patients' 1st and 3rd month controls; we saw that achalasia surgery was performed successfully in our clinic. An important deficiency is that laparoscopic surgery is not yet performed at our desired level in our clinic.

Anahtar Kelimeler

Achalasia, Heller

Kaynakça

• 1. Lindman BR, Clavel M-A, Mathieu P, et al. Calcific aortic stenosis. Nat Rev Dis Prim. 2016; 2: 16006.
• 2. Eveborn GW, Schirmer H, Heggelund G, et al. The evolving epidemiology of valvular aortic stenosis. theTromsø Study. Heart. 2013 Mar 15; 99: 396–400.
• 3. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am CollCardiol. 2014 Jun 10; 63: e57-185.
• 4. Bagur R, Webb JG, Nietlispach F, et al. Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement. Eur Heart J. 2010 Apr 1; 31: 865–74.
• 5. Najjar M, Salna M, George I. Acute kidney injury after aortic valve replacement: Incidence, risk factors and outcomes. Expert Review of Cardiovascular Therapy. 2015.
• 6. Papa A, Emdin M, Passino C, et al. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. ClinChimActa. 2008 Sep; 395: 27–31.
• 7. Park B-J, Shim J-Y, Lee H-R, et al. Relationship of neutrophil-lymphocyte ratio with arterial stiffness and coronary calcium score. ClinChimActa. 2011 May 12; 412: 925–9.
• 8. Zazula AD, Précoma-Neto D, Gomes AM, et al. An assessment of neutrophils/lymphocytes ratio in patients suspected of acute coronary syndrome. Arq Bras Cardiol. 2008 Jan; 90: 31–6.
• 9. Duffy BK, Gurm HS, Rajagopal V, et al. Usefulness of an Elevated Neutrophil to Lymphocyte Ratio in Predicting Long-Term Mortality After Percutaneous Coronary Intervention. Am J Cardiol. 2006 Apr 1; 97: 993–6.
• 10. Gibson PH, Cuthbertson BH, Croal BL, et al. Usefulness of Neutrophil/Lymphocyte Ratio As Predictor of New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting. Am J Cardiol. 2010 Jan 15; 105: 186–91.
• 11. Rudiger A, Burckhardt OA, Harpes P, et al. The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med. 2006 Jul; 24: 451–4.
• 12. Gibson PH, Croal BL, Cuthbertson BH, et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J. 2007 Nov; 154: 995–1002.
• 13. Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev CardiovascTher. 2013 Jan 10; 11: 55–9.
• 14. Kappetein AP, Head SJ, Généreux P, et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document†. Eur Heart J. 2012 Oct; 33: 2403–18.
• 15. Roques F, Michel P, Goldstone AR, et al. The logistic EuroSCORE. Eur Heart J. 2003 May 1; 24: 882–3.
• 16. Park JJ, Jang HJ, Oh IY, et al. Prognostic value of neutrophil to lymphocyte ratio in patients presenting with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol. 2013;
• 17. Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: A review. Expert Review of Cardiovascular Therapy. 2013.
• 18. Onuk T, Güngör B, Karataş B, et al. Increased neutrophil to lymphocyte ratio is associated with in-hospital mortality in patients with aortic dissection. Clin Lab. 2015; 61.
• 19. Yin Y, Wang J, Wang X, et al. Prognostic value of the neutrophil to lymphocyte ratio in lung cancer: A meta-analysis. Clinics. 2015;
• 20. Turkmen K, Guney I, Yerlikaya FH, et al. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail. 2012; 34: 155–9.
• 21. Erdem E. Neutrophil lymphocyte ratio in aute renal failure. Indian J Nephrol. 2015; 25: 126–7.
• 22. Mozos I, Malainer C, Horbańczuk J, et al. Inflammatory Markers for Arterial Stiffness in Cardiovascular Diseases. Front Immunol. 2017 Aug 31; 8: 1058.
• 23. Li J, Chen Q, Luo X, et al. Neutrophil-to-Lymphocyte Ratio Positively Correlates to Age in Healthy Population. J Clin Lab Anal. 2015 Nov; 29: 437–43.
• 24. Nam S-H, Kang S-G, Song S-W. The Neutrophil-Lymphocyte Ratio Is Associated with Coronary Artery Calcification in Asymptomatic Korean Males: A Cross-Sectional Study. Biomed Res Int. 2017 Feb 9; 2017: 1–8.
• 25. Candela P, Evola S, Lunetta M, et al. The spectrum of risk factors for contrast induced nephropathy in patients undergoing coronary angiography or intervention. J Indian CollCardiol. 2014 Sep 1; 4: 157–61.
• 26. Gürsoy OM, Karakoyun S, Kalçık M, et al. Usefulness of Novel Hematologic Inflammatory Parameters to Predict Prosthetic Mitral Valve Thrombosis. Am J Cardiol. 2014 Mar; 113: 860–4.
• 27. Ram P, Mezue K, Pressman G, et al. Acute kidney injury post-transcatheter aortic valve replacement. ClinCardiol. 2017 Dec 1; 40: 1357–62.