Dr Zaninotto and colleagues reported the very long-term results after surgery for esophageal achalasia.
The team assessed long-term subjective outcomes after cardiomyotomy and partial fundoplication, focusing specifically on the risk of esophageal cancer.
Clinical and demographic information from 228 consecutive patients who had surgery between 1980 and 1992 was extracted from hospital files.
Survival status and dates of death were obtained from census offices.
Causes of death were obtained from public registries and compared with those of the general population.
|Almost 90% were satisfied with the treatment|
|British Journal of Surgery |
The researchers assessed symptoms by means of a questionnaire, and endoscopy results were scrutinized.
Among 226 patients who could be traced, 182 of 184 survivors were contacted, and the cause of death established for 41 of 42 patients.
At a median follow-up of 18 years, almost 90% of patients were satisfied with the treatment.
The research team found that 4 had developed squamous cell esophageal carcinoma at 2, 8, 13 and 18 years after surgery, of which 1 was still alive.
The standardized mortality ratio for esophageal carcinoma was significantly higher than expected in men.
Dr Zaninotto’s team concluded, “Cardiomyotomy and partial fundoplication is an excellent long-term treatment for achalasia.”
“Men with achalasia have an increased risk of developing oesophageal cancer.”