Abstract
Modern approach to benign oesophageal disease comprises endoscopic, laparoscopic and open surgical procedures. The indication for a surgical procedure is in some patients obvious, but in some patients less clear. It is important for patients and for healthcare professionals to have equal goals and expectations of a surgical procedure. The aim of this chapter is to convey to the reader a surgeon’s view on the limitations of surgery for benign oesophageal disease without technical discussions of less interest to non-surgical professionals. Incidence, pathogenesis, imaging, diagnosis, differential diagnoses, treatment, side effects and complications are discussed for most of the common benign disorders such as gastro-oesophageal reflux disease, hernias, strictures, achalasia, eosinophilic oesophagitis, diverticula, haemorrhage, foreign bodies and perforations. Symptoms, and objective findings of failed open or minimally invasive surgical procedures, commonly known by operating surgeons only, are briefly discussed and related to normal postoperative expectations and findings.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Attwood SE, Smyrk TC, Demeester TR, Jones JB (1993) Esophageal eosinophilia with dysphagia. A distinct clinicopathologic syndrome. Dig Dis Sci 38(1):109–116
Awaiz A, Yunus RM, Khan S, Memon B, Memon MA (2017) Systematic review and meta-analysis of perioperative outcomes of peroral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) for Achalasia. Surg Laparosc Endosc Percutan Tech 27(3):123–131
Beard K, Swanstrom LL (2017) Zenker's diverticulum: flexible versus rigid repair. J Thorac Dis 9(Suppl 2):S154–SS62
Bekkerman M, Sachdev AH, Andrade J, Twersky Y, Iqbal S (2016) Endoscopic management of foreign bodies in the gastrointestinal tract: a review of the literature. Gastroenterol Res Pract 2016:8520767
Bennett JR (1988) Aetiology, pathogenesis, and clinical manifestations of gastro-oesophageal reflux disease. Scand J Gastroenterol Suppl 146:67–72
Birk M, Bauerfeind P, Deprez PH, Hafner M, Hartmann D, Hassan C et al (2016) Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 48(5):489–496
Boeckxstaens GE, Zaninotto G, Richter JE (2014) Achalasia. Lancet 383(9911):83–93
Brinster CJ, Singhal S, Lee L, Marshall MB, Kaiser LR, Kucharczuk JC (2004) Evolving options in the management of esophageal perforation. Ann Thorac Surg 77(4):1475–1483
Carrott PW Jr, Low DE (2011) Advances in the management of esophageal perforation. Thorac Surg Clin 21(4):541–555
Dasari BV, Neely D, Kennedy A, Spence G, Rice P, Mackle E et al (2014) The role of esophageal stents in the management of esophageal anastomotic leaks and benign esophageal perforations. Ann Surg 259(5):852–860
De Giorgi F, Palmiero M, Esposito I, Mosca F, Cuomo R (2006) Pathophysiology of gastro-oesophageal reflux disease. Acta Otorhinolaryngol Ital 26(5):241–246
Dent J (2008) Pathogenesis of gastro-oesophageal reflux disease and novel options for its therapy. Neurogastroenterol Motil 20(Suppl 1):91–102
Dent J, El-Serag HB, Wallander MA, Johansson S (2005) Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 54(5):710–717
Devaney EJ, Lannettoni MD, Orringer MB, Marshall B (2001) Esophagectomy for achalasia: patient selection and clinical experience. Ann Thorac Surg 72(3):854–858
Elliott EJ, Thomas D, Markowitz JE (2010) Non-surgical interventions for eosinophilic esophagitis. Cochrane Database Syst Rev 3:CD004065
El-Serag HB, Sweet S, Winchester CC, Dent J (2014) Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 63(6):871–880
Falkenback D, Johansson J, Oberg S, Kjellin A, Wenner J, Zilling T et al (2003) Heller's esophagomyotomy with or without a 360 degrees floppy Nissen fundoplication for achalasia. Long-term results from a prospective randomized study. Dis Esophagus 16(4):284–290
Falkenback D, Oberg S, Johnsson F, Johansson J (2009) Is the course of gastroesophageal reflux disease progressive? A 21-year follow-up. Scand J Gastroenterol 44(11):1277–1287
Ferguson DD (2005) Evaluation and management of benign esophageal strictures. Dis Esophagus 18(6):359–364
Gasiorowska A, Fass R (2008) The proton pump inhibitor (PPI) test in GERD: does it still have a role? J Clin Gastroenterol 42(8):867–874
Ginsberg GG (1995) Management of ingested foreign objects and food bolus impactions. Gastrointest Endosc 41(1):33–38
Gmeiner D, von Rahden BH, Meco C, Hutter J, Oberascher G, Stein HJ (2007) Flexible versus rigid endoscopy for treatment of foreign body impaction in the esophagus. Surg Endosc 21(11):2026–2029
Gurvits GE (2010) Black esophagus: acute esophageal necrosis syndrome. World J Gastroenterol 16(26):3219–3225
Herbella FA, Patti MG (2012) Modern pathophysiology and treatment of esophageal diverticula. Langenbecks Arch Surg 397(1):29–35
Hermansson M, Johansson J, Gudbjartsson T, Hambreus G, Jonsson P, Lillo-Gil R et al (2010) Esophageal perforation in South of Sweden: results of surgical treatment in 125 consecutive patients. BMC Surg 10:31
Johansson J, Oberg S, Wenner J, Zilling T, Johnsson F, von Holstein CS et al (2009) Impact of proton pump inhibitors on benign anastomotic stricture formations after esophagectomy and gastric tube reconstruction: results from a randomized clinical trial. Ann Surg 250(5):667–673
Kahrilas PJ, Bredenoord AJ, Fox M, Gyawali CP, Roman S, Smout AJ et al (2015) The Chicago classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil 27(2):160–174
Katzka DA, Castell DO (2011) Review article: an analysis of the efficacy, perforation rates and methods used in pneumatic dilation for achalasia. Aliment Pharmacol Ther 34(8):832–839
Krause W, Roberts J, Garcia-Montilla RJ (2016) Bowel in chest: type IV hiatal hernia. Clin Med Res 14(2):93–96
Leyden JE, Moss AC, MacMathuna P (2014) Endoscopic pneumatic dilation versus botulinum toxin injection in the management of primary achalasia. Cochrane Database Syst Rev 12:CD005046
Li Y, Wu JH, Meng Y, Zhang Q, Gong W, Liu SD (2016) New devices and techniques for endoscopic closure of gastrointestinal perforations. World J Gastroenterol 22(33):7453–7462
Liguori C, Gagliardi N, Saturnino PP, Pinto A, Romano L (2016) Multidetector computed tomography of pharyngo-esophageal perforations. Semin Ultrasound CT MR 37(1):10–15
Lucendo AJ, Molina-Infante J, Arias A, von Arnim U, Bredenoord AJ, Bussmann C et al (2017) Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J 5(3):335–358
Markar SR, Mackenzie H, Wiggins T, Askari A, Karthikesalingam A, Faiz O et al (2018) Influence of national centralization of oesophagogastric cancer on management and clinical outcome from emergency upper gastrointestinal conditions. Br J Surg 105(1):113–120
Marlais M, Fishman JR, Fell JM, Haddad MJ, Rawat DJ (2011) UK incidence of achalasia: an 11-year national epidemiological study. Arch Dis Child 96(2):192–194
McCarty TR, Njei B (2016) Self-expanding metal stents for acute refractory esophageal variceal bleeding: a systematic review and meta-analysis. Dig Endosc 28(5):539–547
Moole H, Jacob K, Duvvuri A, Moole V, Dharmapuri S, Boddireddy R et al (2017) Role of endoscopic esophageal dilation in managing eosinophilic esophagitis: a systematic review and meta-analysis. Medicine (Baltimore) 96(14):e5877
Moonen A, Busch O, Costantini M, Finotti E, Tack J, Salvador R et al (2017) Economic evaluation of the randomized European Achalasia trial comparing pneumodilation with Laparoscopic Heller myotomy. Neurogastroenterol Motil 29(11). https://doi.org/10.1111/nmo.13115
do Nascimento FA, Lemme EM, Costa MM (2006) Esophageal diverticula: pathogenesis, clinical aspects, and natural history. Dysphagia 21(3):198–205
Pandolfino JE, Kwiatek MA, Nealis T, Bulsiewicz W, Post J, Kahrilas PJ (2008) Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology 135(5):1526–1533
Qi X, Tian Y, Zhang W, Zhao H, Han G, Guo X (2016) Covered TIPS for secondary prophylaxis of variceal bleeding in liver cirrhosis: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 95(50):e5680
Remedios M, Jones D, Kerlin P (2011) Eosinophilic oesophagitis: epidemiology, pathogenesis and management. Drugs 71(5):527–540
Rickenbacher N, Kotter T, Kochen MM, Scherer M, Blozik E (2014) Fundoplication versus medical management of gastroesophageal reflux disease: systematic review and meta-analysis. Surg Endosc 28(1):143–155
Rohof WO, Salvador R, Annese V, Bruley d, Varannes S, Chaussade S, Costantini M et al (2013) Outcomes of treatment for achalasia depend on manometric subtype. Gastroenterology 144(4):718–725. quiz e13–4
Ronkainen J, Aro P, Storskrubb T, Lind T, Bolling-Sternevald E, Junghard O et al (2006) Gastro-oesophageal reflux symptoms and health-related quality of life in the adult general population--the Kalixanda study. Aliment Pharmacol Ther 23(12):1725–1733
Sadowski DC, Ackah F, Jiang B, Svenson LW (2010) Achalasia: incidence, prevalence and survival. A population-based study. Neurogastroenterol Motil 22(9):e256–e261
Sdralis EIK, Petousis S, Rashid F, Lorenzi B, Charalabopoulos A (2017) Epidemiology, diagnosis, and management of esophageal perforations: systematic review. Dis Esophagus 30(8):1–6
Shenfine J, Hayes N, Richardson DL, Griffin SM (2001) Combined percutaneous-endoscopic management of a perforated esophagus: a novel technique. Gastrointest Endosc 54(5):649–651
Siersema PD (2006) Therapeutic esophageal interventions for dysphagia and bleeding. Curr Opin Gastroenterol 22(4):442–447
Sonbare DJ (2015) Pulsion diverticulum of the oesophagus: more than just an out pouch. Indian J Surg 77(1):44–48
Spechler SJ (2003) The natural history of dysplasia and cancer in esophagitis and Barrett esophagus. J Clin Gastroenterol 36(5 Suppl):S2–S5. discussion S26–8
Tjwa ET, Holster IL, Kuipers EJ (2014) Endoscopic management of nonvariceal, nonulcer upper gastrointestinal bleeding. Gastroenterol Clin North Am 43(4):707–719
Vela MF, Richter JE, Wachsberger D, Connor J, Rice TW (2004) Complexities of managing achalasia at a tertiary referral center: use of pneumatic dilatation, Heller myotomy, and botulinum toxin injection. Am J Gastroenterol 99(6):1029–1036
Wahed S, Dent B, Jones R, Griffin SM (2014) Spectrum of oesophageal perforations and their influence on management. Br J Surg 101(1):e156–e162
Wen ZH, Gardener E, Wang YP (2004) Nitrates for achalasia. Cochrane Database Syst Rev 1:CD002299
White RK, Morris DM (1992) Diagnosis and management of esophageal perforations. Am Surg 58(2):112–119
Wood RK, Yang YX (2008) Barrett's esophagus in 2008: an update. Keio J Med 57(3):132–138
Zaninotto G, Portale G, Costantini M, Zanatta L, Salvador R, Ruol A (2011) Therapeutic strategies for epiphrenic diverticula: systematic review. World J Surg 35(7):1447–1453
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Johansson, J. (2018). Surgery in Benign Oesophageal Disease. In: Ekberg, O. (eds) Dysphagia. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2018_178
Download citation
DOI: https://doi.org/10.1007/174_2018_178
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-68571-7
Online ISBN: 978-3-319-68572-4
eBook Packages: MedicineMedicine (R0)