Contemporary diagnosis and treatment of cardia achalasia

Abstract

Introduction. Incomplete elucidation of the etiology and pathogenesis of achalasia of the esophagus requires different opinions on diagnostic and treatment of the disease. Aims. Evaluationof diagnostic methods of the esophagus achalasia. Material and methods.The study included 22 patients with various stages of esophagus achalasia: St.II-10 (45%), St.III-9 (40%),St.III-IV-l (5%), St.IV-2 (10%) treated at IMSP SCR, Thoracic Surgery Department between 01.01.2012 and 31.12.2013. To asses the morpho-functional state of the esophagus the following diagnosis methods were used: barium contrast radiography of the esophagus and stomach, thorax radiography, FGDs and histopathological examination. Rezults. Conservative treatment was indicated in 5(22,7%) cases, surgery was performed in 17(77.3%), 14 patients (82,5) were performed extramucous Heller cardiom yotom y with fundaplication Dor, 1(5,9%) case - Heller-Dor laparoscopy, 1(5,9%) case Heller-D or with hiatal hernioplasty and 1(5,9%) case Heller-Neissen. Concluzions. The methods of choice in diagnosis of the esophagus achalasia are barium contrast of the esophagus, esophagoscopy. Conservative treatment is indicated in patients with achalasia of the esophagus in stage one or in presence of contraindications for surgery. The method of choice in the treatment of esophagus achalasia is extra mucous cardiomyotomy with laparoscopic video Heller-Dor indicated in stage II-IV.