Esophagectomy for end-stage achalasia - is it too aggressive?

Nikhil R. Kundu, Sarah K. Thompson

Research output: Contribution to journalReview article

Abstract

Achalasia is a progressively worsening primary motility disorder of the esophagus, characterised by a lack of peristalsis and impaired relaxation of the lower esophageal sphincter. The management of this disease aims to palliate symptoms by improving gastric emptying and reducing the pressure gradient. Nonetheless, approximately 5% of patients will progress to end-stage disease with the development of a massively dilated and tortuous megaesophagus. Esophagectomy for the treatment of end-stage achalasia remains a controversial topic and has been recommended as a last resort by the 2018 International Society for Diseases of the Esophagus guidelines. We describe a patient with end-stage achalasia who had exhausted conventional therapy and was successfully managed with an Ivor Lewis esophagectomy, followed by a review of current practice regarding the management of this difficult problem.
Original languageEnglish
Number of pages6
Journalannals of esophagus
DOIs
Publication statusE-pub ahead of print - 7 May 2020

Keywords

  • End-stage achalasia
  • esophagectomy
  • megaesophagus
  • esophageal resection

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