{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:28:33Z","timestamp":1787020113264,"version":"build-2736575974"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Achalasia is a rare esophageal disease with potentially lethal complications. Knowledge of the outcomes of the different surgical treatment modalities for achalasia by Heller\u2019s cardiomyotomy (HCM) helps to choose the safest and most effective option. However, data on the management of achalsia using a Heller myotomy is limited in Africa. Thus, our aim was to determine the perioperative morbidity, mortality and short-term functional outcomes of HCM in Cameroon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>We conducted a cohort study throughout a 10-year chart review of patients who underwent HCM for achalasia and were followed up postoperatively for at least three months at two tertiary health centers in Cameroon. We analyzed demographic data, preoperative clinical and imaging data, treatment details, and outcomes at three to twelve months after HCM using the Eckardt score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We enrolled 29 patients with achalasia having a mean age of 24\u2009\u00b1\u200916 years and predominantly females (M\/F of 1\/3.8). The mean symptom duration was 51\u2009\u00b1\u200920 months. In 80% of cases, the diagnosis was made through a conventional x-ray contrast imaging or \u201cbarium swallow test\u201d (93%) and\/or an upper gastrointestinal endoscopy (86%). The gold standard diagnostic method via esophageal manometry was unavailable. Preoperatievly, all patients had symptoms suggestive of an active achalasia. HCM was performed via laparotomy in 75% as opposed to 25% laparoscopic HCM procedures. Dor\u2019s anterior partial fundoplication was the main anti-reflux procedure performed (59%). Mucosal perforations were the only intraoperative complications in eight patients (2 during laparoscopy vs. 6 during laparotomy;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.5) and were managed successfully by simple sutures. Postoperative complications were non-severe and occurred in 10% of patients all operated via laparotomy. The mean postoperative length of hospital stay was 7\u2009\u00b1\u20093 days for laparotomy vs. 5\u2009\u00b1\u20092 days for laparoscopy;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.5. The perioperative mortality rate was nil. Overall, the short-term postoperative functional outcome was rated excellent; average Eckardt score of 1.5\u2009\u00b1\u20090.5 (vs. preoperative Eckardt Score of 9\u2009\u00b1\u20091;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Achalasia is diagnosed late in this resource-limited setting. HCM yields satisfactory outcomes, especially via laparoscopic management. An improvement in diagnostic esophageal manometry and mini-invasive surgical infrastructure and the required surgical training\/skills are needed for optimal achalasia care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-024-03191-1","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T05:02:32Z","timestamp":1711083752000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Perioperative outcomes of the surgical management of achalasia in two tertiary Cameroonian hospitals: a cohort study"],"prefix":"10.1186","volume":"24","author":[{"given":"Jo\u00ebl Igor","family":"Kamla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy Aristide","family":"Bang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel Noutakdie","family":"Tochie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George Motto","family":"Bwelle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blondel Nana","family":"Oumarou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette Ngo","family":"Nonga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"issue":"5","key":"3191_CR1","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/S0021-7697(08)74651-9","volume":"145","author":"M Leconte","year":"2008","unstructured":"Leconte M, Douard R, Gaudric M, Dousset B. Traitement Chirurgical Des troubles moteurs de l\u2019\u0153sophage. Journal De Chirurgie. 2008;145(5):428\u201336.","journal-title":"Journal De Chirurgie"},{"key":"3191_CR2","doi-asserted-by":"publisher","first-page":"e256","DOI":"10.1111\/j.1365-2982.2010.01511.x","volume":"22","author":"DC Sadowski","year":"2010","unstructured":"Sadowski DC, Ackah F, Jiang B, Svenson LW. Achalasia: incidence, prevalence and survival. A population-based study. Neurogastroenterol Motil. 2010;22:e256.","journal-title":"Neurogastroenterol Motil"},{"issue":"8","key":"3191_CR3","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1136\/gut.33.8.1011","volume":"33","author":"PJ Howard","year":"1992","unstructured":"Howard PJ, Maher L, Pryde A, Aameron EW, Heading RC. Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh. Gut. 1992;33(8):1011\u20135.","journal-title":"Gut"},{"issue":"38","key":"3191_CR4","doi-asserted-by":"publisher","first-page":"8615","DOI":"10.3748\/wjg.v22.i38.8615","volume":"22","author":"A Tebaibia","year":"2016","unstructured":"Tebaibia A, Boudjella MA, Boutarene D, Benmediouni F, Brahimi H, Oumnia N. Incidence, clinical features and para-clinical findings of achalasia in Algeria: experience of 25 years. World J Gastroenterol. 2016;22(38):8615\u201323.","journal-title":"World J Gastroenterol"},{"issue":"7","key":"3191_CR5","first-page":"261","volume":"67","author":"CM Stein","year":"1985","unstructured":"Stein CM, Gelfand M, Taylor HG. Achalasia in Zimbabwean blacks. S Afr Med J. 1985;67(7):261\u20132.","journal-title":"S Afr Med J"},{"issue":"8\u20139","key":"3191_CR6","first-page":"496","volume":"37","author":"EC Ndjitoyap Ndam","year":"1990","unstructured":"Ndjitoyap Ndam EC, Guemne TA, Tzeuton C, Kamdem P, Sosso A, Nguimbous JF, et al. M\u00e9gaoesophage idiopathique de l\u2019adulte camerounais: \u00e0 propos de quatre observations. M\u00e9d Afr Noire. 1990;37(8\u20139):496\u20138.","journal-title":"M\u00e9d Afr Noire"},{"key":"3191_CR7","unstructured":"Oumarou BN, Bang GA, Guifo M le, Noah R, Savom DN, Essomba EP. A. Cardiomyotomie De Heller Laparoscopique: \u00c0 Propos D\u2019un Cas op\u00e9r\u00e9 Au Centre Hospitalier d\u2019Essos. Health Sci Disease. 2016;17(3)."},{"key":"3191_CR8","unstructured":"Spechler Stuart J, Talley NJ, Robson KM. Achalasia: Pathogenesis, clinical manifestations, and diagnosis. UpToDate, 2021."},{"key":"3191_CR9","doi-asserted-by":"crossref","unstructured":"Schlottmann F, Patti M. Esophageal achalasia: current diagnosis and treatment. Expert Rev Gastroenterol Hepatol. 2018;12.","DOI":"10.1007\/978-3-319-91830-3"},{"issue":"10","key":"3191_CR10","doi-asserted-by":"publisher","first-page":"2144","DOI":"10.1038\/ajg.2010.263","volume":"105","author":"I Leeuwenburgh","year":"2010","unstructured":"Leeuwenburgh I, Scholten P, Alderliesten J, Tilanus HW, Looman CWN, Steijerberg EW, et al. Long-term esophageal cancer risk in patients with primary achalasia: a prospective study. Am J Gastroenterol. 2010;105(10):2144\u20139.","journal-title":"Am J Gastroenterol"},{"issue":"6","key":"3191_CR11","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1111\/j.1365-2036.2006.03079.x","volume":"15","author":"JM Lake","year":"2006","unstructured":"Lake JM, Wong RK. Review article: the management of achalaisa-a comparison of different modalities. Aliment Pharmacol Ther. 2006;15(6):909\u2013.\u2013\u200918.Review.","journal-title":"Aliment Pharmacol Ther"},{"key":"3191_CR12","unstructured":"Spechler Stuart J, Talley NJ, Travis AC. Overview of the treatment of achalasia. UpToDate, 2017."},{"issue":"1","key":"3191_CR13","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1097\/SLA.0b013e31818e43ab","volume":"249","author":"GM Campos","year":"2009","unstructured":"Campos GM, Vittinghoff E, Rabl C, Takata M, Gadenstatter M, Lin F, et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg. 2009;249(1):45\u201357.","journal-title":"Ann Surg"},{"key":"3191_CR14","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1155\/2013\/708327","volume":"2013","author":"G Torres-Villalobos","year":"2013","unstructured":"Torres-Villalobos G, Martin-Del-Campo LA. Surgical treatment for achalasia of the esophagus: Laparoscopic HELLER myotomy. Gastroenterol Res Pract. 2013;2013:5.","journal-title":"Gastroenterol Res Pract"},{"issue":"25","key":"3191_CR15","first-page":"957","volume":"63","author":"W Silber","year":"1983","unstructured":"Silber W. The prevalence, course and management of some benign oesophageal diseases in the black population. The Groote Schuur Hospital experience. S Afr Med J. 1983;63(25):957\u20139.","journal-title":"S Afr Med J"},{"key":"3191_CR16","unstructured":"Razafimahefa S, Rakotondrainibe A et al. Razafitahinjanahary2 C, Rasoaherinomenjanahary F, Rabenjanahary1 T, Rakotovao2 M, Rakotondrainibe A. L\u2019achalasie oesophagienne dans un pays \u00e0 faibles ressources. M\u00e9decine d\u2019Afrique noire. 2012;59:517\u201322."},{"issue":"2","key":"3191_CR17","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","volume":"250","author":"PA Clavien","year":"2009","unstructured":"Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg ao\u00fbt. 2009;250(2):187\u201396.","journal-title":"Ann Surg ao\u00fbt"},{"key":"3191_CR18","unstructured":"Tebaibia Amar BM, Amine O, Nadia L, Mustapha. Touchene Brahim. Place De La dilatation pneumatique dans la prise en charge de L\u2019achalasie Au cours de la grossesse. JFHOD. 2007."},{"key":"3191_CR19","unstructured":"Yaqini K, B\u00e9niaz FZ, Mouhaoui M, Moussaoui M, Louardi H. Cas rare de dysphagie r\u00e9v\u00e9lant une achalasie de l\u2019\u0153sophage. J Marocain Des Sci M\u00e9dicales. 2014;19(1)."},{"key":"3191_CR20","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1023\/A:1018855327960","volume":"42","author":"VF Eckardt","year":"1997","unstructured":"Eckardt VF, K\u00f6hne U, Junginger T. Coll. Risk factors for diagnostic delay in achalasia. Dig Dis Sci. 1997;42:580\u20135.","journal-title":"Dig Dis Sci"},{"issue":"6","key":"3191_CR21","doi-asserted-by":"publisher","first-page":"e13287","DOI":"10.1111\/nmo.13287","volume":"30","author":"TH Taft","year":"2018","unstructured":"Taft TH, Carlson DA, Triggs J, Craft J, Starkey K, Yadlapati R, et al. Evaluating the reliability and construct validity of the Eckardt Symptom Score as a measure of Achalasia Severity. Neurogastroenterol Motil. 2018;30(6):e13287.","journal-title":"Neurogastroenterol Motil"},{"issue":"1","key":"3191_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.gtc.2012.11.001","volume":"42","author":"DA Carlson","year":"2013","unstructured":"Carlson DA, Pandolfino JE. High-resolution manometry and esophageal pressure topography: filling the gaps of convention manometry. Gastroenterol Clin North Am. 2013;42(1):1\u201315.","journal-title":"Gastroenterol Clin North Am"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-024-03191-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-024-03191-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-024-03191-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T05:09:51Z","timestamp":1711084191000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-024-03191-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,22]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3191"],"URL":"https:\/\/doi.org\/10.1186\/s12876-024-03191-1","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,22]]},"assertion":[{"value":"24 March 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was performed in accordance with the 1975 Declaration of Helsinki (6th revision, 2008). The study was approved by the ethics committee of the Faculty of Medicine and Biomedical Sciences of the University of Yaounde I in which requirement for informed consent was waived owing to the retrospective nature of the study (approval number 227\/UY1\/FMSB\/VDRC\/DAASR\/CSD\/2021). The consent to participate was waived by the Ethics Committee of the Faculty of Medicine and Biomedical Sciences of the University of Yaounde I, Cameroon. A copy is available upon request. Administrative approval was obtained from all the two study settings.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"118"}}