{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:10:06Z","timestamp":1792487406518,"version":"4.5.0"},"reference-count":14,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Col. Bras. Cir."],"abstract":"<jats:p>ABSTRACT  Objective:  to analyze the surgical treatment of patients with recurrent megaesophagus followed at the esophageal-stomach-duodenal outpatient clinic of the Hospital de Cl\u00ednicas - UNICAMP.  Methods: a retrospective study, from 2011 to 2017, with 26 patients with Chagas or idiopathic megaesophagus, surgically treated, and who recurred with dysphagia. Clinical, endoscopic and radiographic aspects were assessed and correlated with the performed surgical procedures.  Results:  50% had dysphagia for liquids, 69% regurgitation, 65.3% heartburn, 69.2% weight loss and 69.2% had Chagas disease. In addition, 38.4% had megaesophagus stage 1 and 2 and 61.5% stage 3 and 4. Regarding the reoperations, 53% of them underwent Heller-Pinotti surgery by laparoscopy, Serra-D\u00f3ria in 30.7% and esophageal mucosectomy in 7.9%. In 72% of the reoperations there were no postoperative complications, and 80% of the patients had a good outcome, with reduction or elimination of dysphagia. Among the reoperated patients undergoing the laparoscopic Heller-Pinotti technique, three reported little improvement of dysphagia in the postoperative period and among those who underwent Serra-D\u00f3ria surgery, 100% had no dysphagia. It was observed that, when the time between the first procedure and the reoperation was longer, the better the surgical result was, with statistical significant decreased dysphagia (p=0.0013, p&lt;0.05).  Conclusions:  there was a preference to perform laparoscopic re-miotomy and, as a second option, Serra-D\u00f3ria surgery, for patients with recurrent megaesophagus. Esophagectomy or esophageal mucosectomy were reserved for more severe patients.<\/jats:p>","DOI":"10.1590\/0100-6991e-20202444","type":"journal-article","created":{"date-parts":[[2020,6,7]],"date-time":"2020-06-07T12:28:53Z","timestamp":1591532933000},"source":"Crossref","is-referenced-by-count":6,"title":["Surgical treatment of relapsed megaesophagus"],"prefix":"10.1590","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9212-2993","authenticated-orcid":false,"given":"LUIGI CARLO DA SILVA","family":"COSTA","sequence":"first","affiliation":[{"name":"UNICAMP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JO\u00c3O GABRIEL ROMERO","family":"BRAGA","sequence":"additional","affiliation":[{"name":"UNICAMP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"VALDIR","family":"TERCIOTI JUNIOR","sequence":"additional","affiliation":[{"name":"UNICAMP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JO\u00c3O DE SOUZA","family":"COELHO NETO","sequence":"additional","affiliation":[{"name":"UNICAMP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOS\u00c9 ANT\u00d4NIO POSSATTO","family":"FERRER","sequence":"additional","affiliation":[{"name":"UNICAMP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LUIZ ROBERTO","family":"LOPES","sequence":"additional","affiliation":[{"name":"UNICAMP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NELSON ADAMI","family":"ANDREOLLO","sequence":"additional","affiliation":[{"name":"UNICAMP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2020]]},"reference":[{"issue":"9","key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/dote\/doy071","article-title":"The 2018 ISDE achalasia guidelines","volume":"31","author":"Zaninotto G","year":"2018","journal-title":"Diseases of the Esophagus"},{"issue":"20","key":"ref2","doi-asserted-by":"crossref","first-page":"1942","DOI":"10.1056\/NEJMe1403689","article-title":"Advancing the treatment for Chagas' disease","volume":"370","author":"Albajar-Vi\u00f1as P","year":"2014","journal-title":"N Engl J Med"},{"issue":"3","key":"ref3","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1590\/0037-8682-0065-2013","article-title":"Current epidemiological profile of Chagasic megaesophagus in Central Brazil","volume":"46","author":"Souza DH","year":"2013","journal-title":"Rev Soc Bras de Med Trop"},{"issue":"4","key":"ref4","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1089\/lap.2016.0594","article-title":"Multidisciplinary approach to esophageal achalasia a single center experience","volume":"27","author":"Schlottmann F","year":"2017","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"2","key":"ref5","article-title":"Avalia\u00e7\u00e3o diagn\u00f3stica da acalasia do es\u00f4fago dos sintomas \u00e0 classifica\u00e7\u00e3o de chicago","volume":"31","author":"Laurino Neto RM","year":"2018","journal-title":"ABCD Arq Bras Cir Dig"},{"issue":"4","key":"ref6","article-title":"Comparative analysis of late results of cervical esophagogastric anastomosis by manual and mechanical suture in patients submitted to esophageal mucosectomy through advanced megaesophagus","volume":"32","author":"Aquino JLB","year":"2019","journal-title":"Arq Bras Cir Dig"},{"issue":"3","key":"ref7","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1590\/S0004-28032004000300004","article-title":"Cardioplasty and Roux-en-Y partial gastrectomy (Serra-D\u00f3ria procedure) for reoperation of achalasia","volume":"41","author":"Ponciano H","year":"2004","journal-title":"Arq Gastroenterol"},{"issue":"7","key":"ref8","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1007\/s00268-014-2901-8","article-title":"Recurrent symptoms after Heller myotomy for achalasia evaluation and treatment","volume":"39","author":"Patti MG","year":"2015","journal-title":"World J Surg"},{"issue":"1","key":"ref9","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1089\/lap.2016.0468","article-title":"Achalasia 2016: Treatment Alternatives","volume":"27","author":"Herbella FA","year":"2017","journal-title":"J Laparoendoscopic Adv Surg Tech A"},{"issue":"4","key":"ref10","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1111\/apt.13888","article-title":"The course of achalasia one to four decades after initial treatment","volume":"45","author":"Sawas T","year":"2017","journal-title":"Aliment Pharmacol Ther"},{"issue":"4","key":"ref11","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1590\/S0100-69912009000400005","article-title":"Tratamento cir\u00fargico do megaes\u00f4fago no Hospital de Cl\u00ednicas da UNICAMP - fatores associados a melhores ou piores resultados","volume":"36","author":"Oliveira GC","year":"2009","journal-title":"Rev Col Bras Cir"},{"key":"ref12","series-title":"Opera\u00e7\u00e3o de Serra-D\u00f3ria no tratamento do megaes\u00f4fago operado com recidiva dos sintomas","author":"Trevenzol HP","year":"2003"},{"issue":"5","key":"ref13","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1007\/s00464-015-4423-3","article-title":"Revisional surgery after failed esophagogastric myotomy for achalasia successful esophageal preservation","volume":"30","author":"Veenstra BR","year":"2016","journal-title":"Surg Endosc"},{"issue":"1","key":"ref14","first-page":"1","article-title":"Cardiomiotomia \u00e0 Heller 100 anos de sucesso. 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Cir","volume":"27","author":"Andreollo NA","year":"2014","journal-title":"Dig"}],"container-title":["Revista do Col\u00e9gio Brasileiro de Cirurgi\u00f5es"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/rcbc\/v47\/0100-6991-rcbc-47-e20202444.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T20:38:48Z","timestamp":1611434328000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0100-69912020000100167&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":14,"alternative-id":["S0100-69912020000100167"],"URL":"https:\/\/doi.org\/10.1590\/0100-6991e-20202444","relation":{},"ISSN":["1809-4546","0100-6991"],"issn-type":[{"value":"1809-4546","type":"electronic"},{"value":"0100-6991","type":"print"}],"subject":[],"published":{"date-parts":[[2020]]},"article-number":"e20202444"}}