{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:43:24Z","timestamp":1773269004550,"version":"3.50.1"},"reference-count":63,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2004,9]]},"abstract":"<jats:p>BACKGROUND: After cardiomyotomy for the treatment of megaesophagus, recurrence of symptoms occur in up to 15% of the patients, but only some require a reoperation. AIM: To evaluate the results of reoperation - cardioplasty with Roux-en-Y partial gastrectomy, a technique proposed by Serra-D\u00f3ria. CASUISTIC AND METHODS: Twenty patients with achalasia previously treated by cardiomyotomy, were retrospectively studied. The etiology of symptoms recurrence was reflux esophagitis in nine (45.0%) patients, healing of the myotomy in five (25.0%), end staging megaesophagus in five (25.0%) and incomplete myotomy in one (5%). Intra and postoperative complications were analyzed. The patients were studied by clinical (dysphagia, regurgitation, heartburn and weight gain), radiological and endoscopic evaluation, in the pre- and postoperative period. RESULTS: Five (25.0%) patients had complications in the immediate postoperative period. No deaths were observed. Dysphagia improved in all the patients. Regurgitation and heartburn almost disappeared in the whole group. Weight was maintained or increased in 64.7% of the patients. Radiological studies showed a decrease in the caliber of the esophagus in 53.0%, while the remaining patients maintained the pre-operative diameter. Endoscopy, performed during the late postoperative period in 17 patients, showed that 6 among the 9 with reflux esophagitis improved; 2 among the 8 with a normal esophagus during the preoperative period, developed esophagitis. CONCLUSIONS: The Serra-D\u00f3ria procedure for the treatment of megaesophagus in patients who had already undergone cardiomyotomy and whose symptoms recurred, presented a low morbidity and no mortality. It offered a significant relief of symptoms with a decrease of the caliber of the esophagus in several patients. The patients also improved with regards to reflux esophagitis. In some cases reflux was still present after surgery. Others with normal esophagus in the preoperative period developed esophagitis.<\/jats:p>","DOI":"10.1590\/s0004-28032004000300004","type":"journal-article","created":{"date-parts":[[2005,4,15]],"date-time":"2005-04-15T14:21:35Z","timestamp":1113574895000},"page":"155-161","source":"Crossref","is-referenced-by-count":29,"title":["Cardioplasty and Roux-en-Y partial gastrectomy (Serra-D\u00f3ria procedure) for reoperation of achalasia"],"prefix":"10.1590","volume":"41","author":[{"given":"Helio","family":"Ponciano","sequence":"first","affiliation":[{"name":"Federal University of Goi\u00e2nia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Cecconello","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leosarte","family":"Alves","sequence":"additional","affiliation":[{"name":"Federal University of Goi\u00e2nia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berivaldo Dias","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Federal University of Goi\u00e2nia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaquim","family":"Gama-Rodrigues","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","first-page":"109","article-title":"Esophageal mucosectomy in the treatment of the advances megaesophagus: analysis of 60 cases","volume":"27","author":"Aquino JLB","year":"2000","journal-title":"Rev Col Bras Cir","ISSN":"https:\/\/id.crossref.org\/issn\/0100-6991","issn-type":"print"},{"key":"ref2","first-page":"16","article-title":"Megaes\u00f4fago chag\u00e1sico: tratamento pela cardioplastia a Thal","volume":"8","author":"Barbosa H","year":"1981","journal-title":"Rev Col Bras Cir","ISSN":"https:\/\/id.crossref.org\/issn\/0100-6991","issn-type":"print"},{"key":"ref3","first-page":"1","article-title":"Tratamento cir\u00fargico do megaes\u00f4fago: duas d\u00e9cadas de experi\u00eancia numa regi\u00e3o end\u00eamica","volume":"35","author":"Barbosa H","year":"1989","journal-title":"Rev Goiana Med","ISSN":"https:\/\/id.crossref.org\/issn\/0034-9585","issn-type":"print"},{"key":"ref4","series-title":"Diseases of the esophagus","first-page":"975","volume-title":"Long-term evaluation of gastroplasty in achalasia","author":"Cecconello I","year":"1988"},{"key":"ref5","author":"Cecconello I","year":"1990"},{"key":"ref6","series-title":"Diseases of the esophagus","first-page":"91","volume-title":"Reflux esophagitis and development of ectopic columnar epithelium in the esophageal stump after gastric transposition: a prospective study","author":"Cecconello I","year":"1993"},{"key":"ref7","series-title":"The esophagogastric junction","first-page":"1441","volume-title":"When fundoplication is added to the miotomy, is there a risk of intra-thoracic migration of the valve after reduction of the esophageal caliber?","author":"Cecconello I","year":"1988"},{"key":"ref8","first-page":"178","article-title":"Tratamento do megaes\u00f4fago pela t\u00e9cnica de Heller-Vasconcelos: Experi\u00eancia de 200 casos","volume":"32","author":"Chaib SA","year":"1977","journal-title":"Rev Hosp Clin Fac Med S\u00e3o Paulo"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/0016-5085(81)90142-6","article-title":"A prospective randomized study comparing forceful dilatation and esophagomyotomy in patients with achalasia of the esophagus","volume":"80","author":"Csendes A","year":"1981","journal-title":"Gastroenterology","ISSN":"https:\/\/id.crossref.org\/issn\/0016-5085","issn-type":"print"},{"key":"ref10","first-page":"474","article-title":"Results of surgical treatment of achalasia of the esophagus","volume":"38","author":"Csendes A","year":"1991","journal-title":"Hepatogastroenterology","ISSN":"https:\/\/id.crossref.org\/issn\/0172-6390","issn-type":"print"},{"key":"ref11","first-page":"587","article-title":"Insuccessi della terapia chirurgica dell\u2019acalasia: diagnosi e trattamento","volume":"66","author":"Del Genio A","year":"1995","journal-title":"Ann Ital Chir","ISSN":"https:\/\/id.crossref.org\/issn\/0003-469X","issn-type":"print"},{"key":"ref12","first-page":"877","article-title":"L\u2019interet de la tecnique de Nissen modifi\u00e9 dans la pr\u00e9vention du reflux apr\u00e9s cardiomiotomie extramuqueuse de Heller","volume":"88","author":"Dor J","year":"1962","journal-title":"Mem Acad Chir"},{"key":"ref13","series-title":"Megaes\u00f4fago n\u00e3o avan\u00e7ado; tratamento pela cardiomiotomia associada \u00e0 esofagofundogastropexia. 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