{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T20:57:00Z","timestamp":1705006620221},"reference-count":26,"publisher":"FapUNIFESP (SciELO)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Cir. Bras."],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:p>PURPOSE: Evaluate anatomical and functional changes of the esophageal stump and gastric fundus of patients with advanced megaesophagus, submitted to laparoscopic subtotal esophagectomy. METHODS: Twenty patients with advanced megaesophagus, previously submitted to a videolaparoscopic subtotal esophagectomy , were evaluated. Were conducted: radiological evaluation of the stump esophagus with transposed stomach, electromanometric, endoscopic examination and histopathology of the esophageal stump and gastric fundus, without making gastric tube or pyloroplasty. RESULTS: It was observed that the average height and pressure of the anastomosis, in the electromanometric evaluation, were 23.45cm (\u00b11.84cm) and 7.55mmHg (\u00b15.65mmHg). In patients with megaesophagus III, the pressure of the anastomosis was 10.91mmHg (\u00b16.33mmHg), and pressure from the UES, 31.89mmHg (\u00b114.64mm Hg), were significantly higher than those in grade IV. The pathological evaluation detected mild esophagitis in 35% of patients, moderate in 20% and acanthosis glicogenica in 45%. The examination of the gastric fundus showed that 50% of patients were infected with Helicobacter pylori. Chronic gastritis occurred in 95% of the patients. CONCLUSIONS: The laparoscopic esophagectomy shown to be effective in the treatment of advanced achalasia. The cervical level anastomosis protects the esophageal stump from the aggression resulted from gastric reflux after the esophagectomy.<\/jats:p>","DOI":"10.1590\/s0102-86502012000900011","type":"journal-article","created":{"date-parts":[[2012,8,29]],"date-time":"2012-08-29T07:29:48Z","timestamp":1346225388000},"page":"650-658","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of anatomical and functional changes esophageal stump of patients with advanced megaesophagus submitted to subtotal laparoscopic esophagectomy"],"prefix":"10.1590","volume":"27","author":[{"given":"J\u00faverson Alves","family":"Terra J\u00fanior","sequence":"first","affiliation":[{"name":"UFTM,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilherme Azevedo","family":"Terra","sequence":"additional","affiliation":[{"name":"UFTM,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex Augusto da","family":"Silva","sequence":"additional","affiliation":[{"name":"UFTM,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Crema","sequence":"additional","affiliation":[{"name":"UFTM,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","first-page":"665","article-title":"Manometric and radiologic aspects of Chagas' megaesophagus: the importance to its surgical treatment","volume":"36","author":"Crema E","year":"2003","journal-title":"Rev Soc Bras Med Trop","ISSN":"http:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/s004280000319","article-title":"Neuron count re-evaluation in the myenteric plexus of chagasic megacolon after morphometric neuron analysis","volume":"438","author":"Adad SJ","year":"2001","journal-title":"Virchows Arch","ISSN":"http:\/\/id.crossref.org\/issn\/0945-6317","issn-type":"print"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1097\/01.sla.0000345936.63500.aa","article-title":"The origins of an operation: a brief history of transhiatal esophagectomy","volume":"249","author":"Dubecz A","year":"2009","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1046\/j.1442-2050.2000.00135.x","article-title":"Reservoir and globe-type antireflux surgical techniques in intrathoracic esophagogastrostomies","volume":"13","author":"Yalav E","year":"2000","journal-title":"J Int Soc Dis Esophagus"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"2903","DOI":"10.1245\/s10434-008-0057-1","article-title":"Barrett's esophagus and carcinoma in the esophageal stump after esophagectomy with gastric pull-up in achalasia patients: a study based on 10 years follow-up","volume":"15","author":"Rocha JR","year":"2008","journal-title":"Ann Surg Oncol","ISSN":"http:\/\/id.crossref.org\/issn\/1068-9265","issn-type":"print"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1097\/PAS.0b013e31822b78e8","article-title":"The dilated distal esophagus: a new entity that is the pathologic basis of early gastroesophageal reflux disease","volume":"35","author":"Chandrasoma P","year":"2011","journal-title":"Am J Surg Pathol","ISSN":"http:\/\/id.crossref.org\/issn\/0147-5185","issn-type":"print"},{"key":"ref7","first-page":"183","article-title":"Surgically treated megaesophagus: epidemiological profile of patients operated in the Clinical Hospital of the State University of Campinas between 1989 and 2005","volume":"41","author":"Oliveira GC","year":"2008","journal-title":"Rev Soc Bras Med Trop","ISSN":"http:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref8","first-page":"99","article-title":"Diagnosis, management and treatment of chronic Chagas' heart disease in areas where Trypanosoma cruzi infection is not endemic","volume":"26","author":"Gasc\u00f3n J","year":"2008","journal-title":"Enferm Infecc Microbiol Clin","ISSN":"http:\/\/id.crossref.org\/issn\/0213-005X","issn-type":"print"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1590\/S0037-86822011005000043","article-title":"Prevalence of cholelithiasis in patients with chagasic megaesophagus","volume":"44","author":"Crema E","year":"2011","journal-title":"Rev Soc Bras Med Trop","ISSN":"http:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/SLA.0b013e31818e43ab","article-title":"Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis","volume":"249","author":"Campos G","year":"2009","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref11","first-page":"69","article-title":"Barrett esophagus in the esophageal stump after subtotal esophagectomy with cervical esophagogastroplasty","volume":"47","author":"Rocha JR","year":"1992","journal-title":"Rev Hosp Clin"},{"issue":"6","key":"ref12","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1093\/icvts\/ivs036","article-title":"Should oesophagectomy be performed with cervical or intrathoracic anastomosis?","volume":"14","author":"Kayani B","year":"2012","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1007\/s00268-007-9325-7","article-title":"Proton pump inhibitors relieve and prevent symptoms related to gastric acidity after esophagectomy","volume":"32","author":"Okuyama M","year":"2008","journal-title":"World J Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0364-2313","issn-type":"print"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1007\/s00268-008-9664-z","article-title":"Endoscopic evaluation of the quality of the anastomosis after esophagectomy with gastric tube reconstruction","volume":"32","author":"Kim HK","year":"2008","journal-title":"World J Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0364-2313","issn-type":"print"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1007\/s00464-007-9653-6","article-title":"Endoscopic and symptomatic assessment of anastomotic strictures following esophagectomy and cervical esophagogastrostomy","volume":"22","author":"Williams VA","year":"2008","journal-title":"Surg Endosc","ISSN":"http:\/\/id.crossref.org\/issn\/0930-2794","issn-type":"print"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.gie.2007.10.047","article-title":"Management of persistent gastroesophageal anastomotic strictures with removable self-expandable polyester silicon-covered (Polyflex) stents: an alternative to serial dilation","volume":"67","author":"Barthel JS","year":"2008","journal-title":"Gastrointest Endosc","ISSN":"http:\/\/id.crossref.org\/issn\/0016-5107","issn-type":"print"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1111\/j.1442-2050.2010.01066.x","article-title":"Effect of bolus volume on proximal esophageal contractions of patients with Chagas' disease and patients with idiopathic achalasia","volume":"23","author":"Dantas RO","year":"2010","journal-title":"Dis Esophagus","ISSN":"http:\/\/id.crossref.org\/issn\/1120-8694","issn-type":"print"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.1442-2050.2008.00849.x","article-title":"The esophageal remnant after gastric interposition","volume":"21","author":"D'Journo XB","year":"2008","journal-title":"J Int Soc Dis Esophagus"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/S1521-6918(04)00090-3","article-title":"Chronic symptoms after subtotal or partial esophagectomy: diagnosis and treatment","volume":"18","author":"Lerut TE","year":"2004","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/SLA.0b013e31818eec06","article-title":"Mucosal damage in the esophageal remnant after esophagectomy and gastric transposition","volume":"249","author":"D'Journo XB","year":"2009","journal-title":"Ann Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0003-4932","issn-type":"print"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s00423-006-0119-4","article-title":"Effect of pyloric drainage procedures on gastric passage and bile reflux after esophagectomy with gastric conduit reconstruction","volume":"392","author":"Palmes D","year":"2007","journal-title":"Langenbeck's Arch Surg"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.bpg.2008.02.002","article-title":"Contribution of histology to the diagnosis of reflux disease","volume":"22","author":"Vieth M","year":"2008","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"ref23","first-page":"1992","article-title":"Five cases of peptic ulcer of gastric tube after radical esophagectomy for esophageal carcinoma and analysis of Helicobacter pylori infection at gastric tube","volume":"45","author":"Takemura M","year":"1997","journal-title":"Nihon Ky\u014dbu Geka Gakkai"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/j.1442-2050.2007.00718.x","article-title":"Helicobacter pylori infection influences the acidity in the gastric tube as an esophageal substitute after esophagectomy","volume":"20","author":"Mori N","year":"2007","journal-title":"J Int Soc Dis Esophagus"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1523-5378.2011.00931.x","article-title":"The association between Barrett's esophagus and Helicobacter pylori infection: a meta-analysis","volume":"17","author":"Fischbach LA","year":"2012","journal-title":"Helicobacter","ISSN":"http:\/\/id.crossref.org\/issn\/1083-4389","issn-type":"print"},{"key":"ref26","first-page":"899","article-title":"Acid-related diseases following retrosternal stomach interposition","volume":"48","author":"Maier A","year":"2001","journal-title":"Hepatogastroenterol"}],"container-title":["Acta Cirurgica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/acb\/v27n9\/v27n9a11.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,5,27]],"date-time":"2017-05-27T09:01:03Z","timestamp":1495875663000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-86502012000900011&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9]]},"references-count":26,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2012,9]]}},"alternative-id":["S0102-86502012000900011"],"URL":"https:\/\/doi.org\/10.1590\/s0102-86502012000900011","relation":{},"ISSN":["0102-8650"],"issn-type":[{"value":"0102-8650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,9]]}}}