{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T15:54:56Z","timestamp":1723650896826},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T00:00:00Z","timestamp":1389139200000},"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":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chagas disease is a serious public health issue in South and Central America due to its high prevalence, morbidity, and mortality. The esophageal form of the disease leads to achalasia and consequent megaesophagus. In advanced or recurrent cases of megaesophagus, there is no consensus for which of three established techniques\u2014the Serra\u2010D\u00f3ria procedure, subtotal esophagectomy, or Modified Thal cardioplasty\u2014is best. Very few studies have investigated the average efficacy and long\u2010term outcomes of the Thal procedure. The present study sought to bridge this gap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Modified Thal procedure was performed in 29 patients at Hospital Universit\u00e1rio de Bras\u00edlia between 1998 and 2008. All underwent clinical and nutritional evaluation, upper gastrointestinal endoscopy (UDE) with chromoscopy, esophageal manometry, and 24\u2010h pH monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 86 % experienced resolution of all symptoms after surgery. Most patients were classified as Visick grade I, II, or III. The average body mass index was 22.7\u00a0kg\/m<jats:sup>2<\/jats:sup>. UDE showed normal mucosa in 76 % of patients, and 11 % had unstained areas on chromoscopy. Esophageal manometry demonstrated incomplete lower esophageal sphincter (LES) relaxation in 50 % of patients, complete LES relaxation in 21 %, and no LES relaxation in 29 %. All showed complete relaxation of the upper esophageal sphincter. On 24\u2010h pH monitoring, reflux was pathological in 50 % of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, the modified Thal procedure improved symptoms\u2014namely, dysphagia to liquids with resulting weight loss and malnutrition\u2014in patients with megaesophagus. No correlations were found between clinical complaints, endoscopic findings, and degree of manometric abnormality in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2445-3","type":"journal-article","created":{"date-parts":[[2014,1,7]],"date-time":"2014-01-07T18:58:49Z","timestamp":1389121129000},"page":"1425-1430","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010Term Results of the Modified Thal Procedure in Patients with Chagasic Megaesophagus"],"prefix":"10.1002","volume":"38","author":[{"given":"Andr\u00e9a Pedrosa Ribeiro","family":"Alves","sequence":"first","affiliation":[{"name":"School of Medicine Universidade de Bras\u00edlia Bras\u00edlia DF Brazil"},{"name":"Hospital Universit\u00e1rio de Bras\u00edlia SGAN 604\/605 Bras\u00edlia DF Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Gon\u00e7alves","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"School of Medicine Universidade de 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