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Revisional Surgery for Achalasia

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Surgical Management of Benign Esophageal Disorders

Abstract

A laparoscopic Heller myotomy with partial fundoplication is considered today the surgical procedure of choice for patients with achalasia. Even though the operation has a very high success rate, dysphagia recurs in some patients. When this happens, it is important to perform a careful work-up to identify the cause and to design a tailored treatment plan. In general, patients with persistent or recurrent dysphagia present with a narrowing of the esophageal lumen (caused by the disease or the incomplete correction of the problem at the initial operation). This narrowing can be dealt with, successfully, by endoscopic means in many patients. Some may need revisional surgery. The best results are obtained in centers where radiologists, gastroenterologists, and surgeons have experience in the diagnosis and treatment of this rare disease. The diagnosis and proper management of patients with recurrent (or residual) dysphagia after Heller myotomy are discussed in this chapter.

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Washington, 1959 NE Pacific St, 356410/ Office BB-487, Seattle, WA, 98195, USA

    Elizabeth A. Warner MD

  2. Department of Surgery, Center for Esophageal Diseases, Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Ave, Chicago, IL, 60637, USA

    Marco G. Patti MD & Marco E. Allaix MD

  3. Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA

    Carlos A. Pellegrini MD

Authors
  1. Elizabeth A. Warner MD
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  2. Marco G. Patti MD
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  3. Marco E. Allaix MD
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  4. Carlos A. Pellegrini MD
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Corresponding author

Correspondence to Carlos A. Pellegrini MD .

Editor information

Editors and Affiliations

  1. Loyola University Medical Center, Maywood, Illinois, USA

    P. Marco Fisichella

  2. Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Nathaniel J. Soper

  3. Department of Surgery, University of Washington Medical Center, Seattle, USA

    Carlos A. Pellegrini

  4. Chicago, Illinois, USA

    Marco G. Patti

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© 2014 Springer-Verlag London

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Warner, E.A., Patti, M.G., Allaix, M.E., Pellegrini, C.A. (2014). Revisional Surgery for Achalasia. In: Fisichella, P., Soper, N., Pellegrini, C., Patti, M. (eds) Surgical Management of Benign Esophageal Disorders. Springer, London. https://doi.org/10.1007/978-1-4471-5484-6_17

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  • DOI: https://doi.org/10.1007/978-1-4471-5484-6_17

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5483-9

  • Online ISBN: 978-1-4471-5484-6

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