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Abstract
es auteurs rapportent une observation d’un cas d’achalasie chez une patiente de 30 ans traité par une cardiomyotomie de Heller laparoscopique. Le retard diagnostique était de 3 ans. L’intervention a été réalisée à l’aide de cinq trocarts, la longueur de la myotomie était de 10 cm. Une brèche muqueuse créée a été suturée et une fundoplicature de DOR a été adjointe. Les suites opératoires ont été simples avec reprise de l’alimentation orale au 3ème jour postopératoire et une sortie au 5ème jour postopératoire. L’usage de l’abord laparoscopique dans le traitement de l’achalasie doit être encouragée dans notre contexte et enseignée, eu égard à ses nombreux avantages.
ABSTRACT
We report a history of an achalasia in a 30 years old patient treated by a laparoscopic Heller myotomy. The diagnosis delay was 3 years. The operation was performed with five trocars and the length of the myotomy was 10 cm. An esophageal perforation occurred during the procedure and was sutured. A DOR fundoplication was performed. The postoperative course was simple with a resumption of oral feeding on the 3rd postoperative day and exit at the 5th postoperative day. The use of the laparoscopic myotomy in the treatment of achalasia should be emphasized and taught in our country given its many advantages.
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References
- CHUAH SK, HSU PI, WU KL, WU DC, TAI WC, CHANGCHIEN CS. 2011 update on esophageal achalasia. World J Gastroenterol 2012;18(14): 1573-1578.
- METMAN E.-H., DEBBABI S., NEGREANU L. Troubles moteurs de l’œsophage. EMC (Elsevier Masson SAS, Paris), Gastro-entérologie, 9-201-A-10, 2006.
- MAYBERRY JF. Epidemiology and demographics of achalasia. Gastrointest Endosc Clin N Am 2001;11(2): 235-48.
- HOWARD PJ, MAHER L, PRYDE A, CAMERON EW, HEADING RC. Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh. Gut 1992;33(8): 1011-5.
- SENG-KEE C, CHIEN-HUA C, WEI-CHEN T. et al. Currents status in the treatment options for esophageal achalasia. World J Gastroenterol 2013; 19(33): 5421-5429.
- CAMPOS GM, VITTINGHOFF E, RABL C, TAKATA M, GADENSTATTER M, LIN F et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg 2009; 249(1): 45-57.
- LOPUSHINSKY SR, URBACH DR. Pneumatic dilatation and surgical myotomy for achalasia. JAMA 2006;296(18): 2227-2233.
- ROSEMURGY AS, MORTON CA, ROSAS M, ALBRINK M, ROSS SB. A single institution’s experience with more than 500 laparoscopic HELLER myotomies for achalasia. J am Coll Surg 2010; 210(5): 637-647.
- HELLER E. Extramukose cardioplastik bein chronischen cardiospasmus mit dilatation des oesophagus. Mitleilungen aus den Grenzgebieten der Medizin und Chirurgie 1913;27:141.
- TORRES-VILLALOBOS G, MARTIN-DEL-CAMPO LA. Surgical treatment for achalasia of the esophagus: Laparoscopic HELLER myotomy. Gastroenterology Research and Practice 2013;2013:5.
- KILIC A, SCHUCHERT MJ, PENNATHUR A, GILBERT S, LANDRENAURT RJ, LUKETICH JD. Long-term outcomes of laparoscopic HELLER myotomy for achalasia. Surgery 2009; 146(4):826-831.
- GOCKEL I, JUNGINGER T, ECKARDT VT. Long-term results of conventional myotomy I patients with achalasia: a prospective 20-year analysis. J Gastrointest Surg 2006;10:1400-1408.
- WANG L, LI YM, LI L. Meta-analysis of randomized and controlled treatment trials for achalasia. Dig Dis Sci 2009;54(11):2303-2311.
- TAKONGMO S, JUIMO AG, BINAM F, MASSO-MISSE P, MALONGA E, EDZOA T. La cardiomyotomie de HELLER dans le traitement du mega-oesophage idiopathique au CHU de Yaoundé. Médecine d’Afrique Noire 1995;42(12):649-652.
- MASSO MISSE P, YAO JG, ABOLO MBENTI L, NDAM EC, KAMDOUM M, GONSU JD et al. Résultats de la myotomie de HELLER pour megaoesophage idiopathique : l’expérience de l’Hôpital Central de Yaoundé, à propos de 9 cas. Med Trop 1994;54(4): 377-8.
- ECKARDT VF, KOHNE U, JUNGINGER T, WESTERMEIER T. Risk factors for diagnostic delay in achalasia. Dig Dis Sci 1997;42:580 - 5.
- ZERBIB F, THETIOT V, RICHY F, BENAJAH DA, MESSAGE L, LAMOULIATTE H. Repeated pneumatic dilatation as long-term maintenance therapy for esophageal achalasia. Am J Gastroenterol 2006; 101(4): 692-697.
- SHIMI S, NATHANSON LK, CUSCHIERI A. Laparoscopic cardiomyotomy for achalasia. J R coll Surg Edinb 1991;36:152-4.
- SHARP KW, KHAITAN L, SCHOLZ S. et al. 100 consecutive minimally invasive Heller myotomies. Lessons learned. Ann Surg 2002;235(5):631-639.
- STEFANIDIS D, RICHARDSON W, FARRELL JM, KOHN G, AUGENSTEIN V, FANELLI RD. SAGES guidelines for the surgical treatment of esophageal achalasia. Surgical Endoscopy 2012;26(2):296-311.
- OELSCHLAGER BK, CHANG L, PELLEGRINI CA. Improved outcome after extended gastric myotomy for achalasia. Arch Surg 2003;138(5):490-495.
- FALKENBACK D, JOHANSSON J, OBERG S et al. Heller’s esophagomyotomy with or without a 360ͦ floppy Nissen fundoplication for achalasia. Long-term results from a prospective randomized study. Diseases of the Esophagus 2003:16(4):284-290.
- RICHARDS WO, TORQUATI A, HOLZMAN MD et al. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia : a prospective randomized double-blind clinical trial. Annals of surgery 2004;240(3):405-415.
References
CHUAH SK, HSU PI, WU KL, WU DC, TAI WC, CHANGCHIEN CS. 2011 update on esophageal achalasia. World J Gastroenterol 2012;18(14): 1573-1578.
METMAN E.-H., DEBBABI S., NEGREANU L. Troubles moteurs de l’œsophage. EMC (Elsevier Masson SAS, Paris), Gastro-entérologie, 9-201-A-10, 2006.
MAYBERRY JF. Epidemiology and demographics of achalasia. Gastrointest Endosc Clin N Am 2001;11(2): 235-48.
HOWARD PJ, MAHER L, PRYDE A, CAMERON EW, HEADING RC. Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh. Gut 1992;33(8): 1011-5.
SENG-KEE C, CHIEN-HUA C, WEI-CHEN T. et al. Currents status in the treatment options for esophageal achalasia. World J Gastroenterol 2013; 19(33): 5421-5429.
CAMPOS GM, VITTINGHOFF E, RABL C, TAKATA M, GADENSTATTER M, LIN F et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg 2009; 249(1): 45-57.
LOPUSHINSKY SR, URBACH DR. Pneumatic dilatation and surgical myotomy for achalasia. JAMA 2006;296(18): 2227-2233.
ROSEMURGY AS, MORTON CA, ROSAS M, ALBRINK M, ROSS SB. A single institution’s experience with more than 500 laparoscopic HELLER myotomies for achalasia. J am Coll Surg 2010; 210(5): 637-647.
HELLER E. Extramukose cardioplastik bein chronischen cardiospasmus mit dilatation des oesophagus. Mitleilungen aus den Grenzgebieten der Medizin und Chirurgie 1913;27:141.
TORRES-VILLALOBOS G, MARTIN-DEL-CAMPO LA. Surgical treatment for achalasia of the esophagus: Laparoscopic HELLER myotomy. Gastroenterology Research and Practice 2013;2013:5.
KILIC A, SCHUCHERT MJ, PENNATHUR A, GILBERT S, LANDRENAURT RJ, LUKETICH JD. Long-term outcomes of laparoscopic HELLER myotomy for achalasia. Surgery 2009; 146(4):826-831.
GOCKEL I, JUNGINGER T, ECKARDT VT. Long-term results of conventional myotomy I patients with achalasia: a prospective 20-year analysis. J Gastrointest Surg 2006;10:1400-1408.
WANG L, LI YM, LI L. Meta-analysis of randomized and controlled treatment trials for achalasia. Dig Dis Sci 2009;54(11):2303-2311.
TAKONGMO S, JUIMO AG, BINAM F, MASSO-MISSE P, MALONGA E, EDZOA T. La cardiomyotomie de HELLER dans le traitement du mega-oesophage idiopathique au CHU de Yaoundé. Médecine d’Afrique Noire 1995;42(12):649-652.
MASSO MISSE P, YAO JG, ABOLO MBENTI L, NDAM EC, KAMDOUM M, GONSU JD et al. Résultats de la myotomie de HELLER pour megaoesophage idiopathique : l’expérience de l’Hôpital Central de Yaoundé, à propos de 9 cas. Med Trop 1994;54(4): 377-8.
ECKARDT VF, KOHNE U, JUNGINGER T, WESTERMEIER T. Risk factors for diagnostic delay in achalasia. Dig Dis Sci 1997;42:580 - 5.
ZERBIB F, THETIOT V, RICHY F, BENAJAH DA, MESSAGE L, LAMOULIATTE H. Repeated pneumatic dilatation as long-term maintenance therapy for esophageal achalasia. Am J Gastroenterol 2006; 101(4): 692-697.
SHIMI S, NATHANSON LK, CUSCHIERI A. Laparoscopic cardiomyotomy for achalasia. J R coll Surg Edinb 1991;36:152-4.
SHARP KW, KHAITAN L, SCHOLZ S. et al. 100 consecutive minimally invasive Heller myotomies. Lessons learned. Ann Surg 2002;235(5):631-639.
STEFANIDIS D, RICHARDSON W, FARRELL JM, KOHN G, AUGENSTEIN V, FANELLI RD. SAGES guidelines for the surgical treatment of esophageal achalasia. Surgical Endoscopy 2012;26(2):296-311.
OELSCHLAGER BK, CHANG L, PELLEGRINI CA. Improved outcome after extended gastric myotomy for achalasia. Arch Surg 2003;138(5):490-495.
FALKENBACK D, JOHANSSON J, OBERG S et al. Heller’s esophagomyotomy with or without a 360ͦ floppy Nissen fundoplication for achalasia. Long-term results from a prospective randomized study. Diseases of the Esophagus 2003:16(4):284-290.
RICHARDS WO, TORQUATI A, HOLZMAN MD et al. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia : a prospective randomized double-blind clinical trial. Annals of surgery 2004;240(3):405-415.