{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T13:58:22Z","timestamp":1756994302412},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[1981,9,1]],"date-time":"1981-09-01T00:00:00Z","timestamp":368150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1981,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>The purpose of this report was to evaluate the efficacy of cardiomyotomy combined with fundoplication in the treatment of achalasia. Results obtained in 15 patients are compared with those collected in 19 asymptomatic patients treated by the classical Heller operation (12 patients), or by cardiomyotomy combined with suture of phrenoesophageal ligament to the underside of the diaphragm (7 patients). The preventive action of fundoplication on reflux esophagitis and especially the effect of surgery on esophageal emptying are particularly examined, using two rigorous isotopic tests. It is demonstrated that even asymptomatic patients have, after cardiomyotomy without antireflux maneuvers, a very high risk of esophagitis. The statistical comparison using the gastroesophageal reflux index between patients treated by Heller cardiomyotomy and normals was<\/jats:bold><jats:bold><jats:italic>p<\/jats:italic><\/jats:bold> &lt;<jats:bold>0.001 to the classical Heller, and 0.01<\/jats:bold> &lt;<jats:bold><jats:italic>p<\/jats:italic><\/jats:bold> &lt;<jats:bold>0.05 to the group treated by cardiomyotomy plus abdominal fixation of the cardia. By contrast, the combination of a fundoplication to the myotomy provided a very high antireflux efficacy<\/jats:bold> (<jats:bold><jats:italic>p<\/jats:italic><\/jats:bold> &gt;<jats:bold>0.1), and maintained the improvement of the esophageal emptying<\/jats:bold>.<\/jats:p>","DOI":"10.1007\/bf01657930","type":"journal-article","created":{"date-parts":[[2005,5,8]],"date-time":"2005-05-08T12:11:54Z","timestamp":1115554314000},"page":"697-702","source":"Crossref","is-referenced-by-count":13,"title":["Cardiomyotomy associated with antireflux surgery in the treatment of achalasia"],"prefix":"10.1002","volume":"5","author":[{"given":"F.","family":"Veiga\u2010Fernandes","sequence":"first","affiliation":[{"name":"Department of Surgery and Laboratory of Nuclear Medicine Faculty of Medicine Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. F.","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Department of Surgery and Laboratory of Nuclear Medicine Faculty of Medicine Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Didia\u2010Guerreiro","sequence":"additional","affiliation":[{"name":"Department of Surgery and Laboratory of Nuclear Medicine Faculty of Medicine Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1981,9]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800631215"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196710000-00012"},{"key":"e_1_2_1_4_1","first-page":"515","article-title":"Echecs et pr\u00e9tendus \u00e9checs de l'op\u00e9ration de Heller pour m\u00e9ga\u2010oesophage idiopatique. \u00c9tude de 55\u00a0malades r\u00e9op\u00e8res","volume":"31","author":"Fekete F.","year":"1977","journal-title":"Ann. Chir. (Paris)"},{"key":"e_1_2_1_5_1","first-page":"482","article-title":"Management of achalasia by transabdominal cardiomyotomy and fundoplication","volume":"133","author":"Menguy R.","year":"1971","journal-title":"Surg. Gynecol. Obstet."},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.30.5.539"},{"key":"e_1_2_1_7_1","first-page":"599","article-title":"Hiatal hernia as a complication of the Heller operation","volume":"49","author":"Forbese A.S.","year":"1960","journal-title":"Surgery"},{"key":"e_1_2_1_8_1","first-page":"1057","article-title":"Primary surgical treatment for esophageal achalasia","volume":"133","author":"Effler D.B.","year":"1971","journal-title":"Surg. Gynecol. Obstet."},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197002000-00006"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)43430-2"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1979.01370280190032"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.33.5.569"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(75)90185-3"},{"key":"e_1_2_1_14_1","first-page":"617","article-title":"Fundic patch operation in the treatment of advanced achalasia of the esophagus","volume":"134","author":"Hatafuku T.","year":"1972","journal-title":"Surg. Gynecol. Obstet."},{"key":"e_1_2_1_15_1","first-page":"23","article-title":"Metodologia para o estudo simult\u00e2neo do esvasiamento e refluxo esof\u00e1gico com c\u00e2mara\u2010gama","volume":"143","author":"Veiga\u2010Fernandes F.","year":"1979","journal-title":"J. Soc. Ci\u00eanc. Med. 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