Achalasia cardiae miatt az első oesophago-cardia myotomiát több mint száz évvel ezelőtt Ernst Heller német sebész végezte. Az achalasiás betegek a mai napig ettől a beavatkozástól várják panaszaik megszűnését. Az achalasia napjainkban is chronikus, progresszív betegség, aminek oki kezelését nem ismerjük, a gyógyítására, a panaszok enyhítésére gyógyszeres (calcium csatorna blokkolók stb.), endoscopos (botulinum toxin inj., ballonos tágítás, per oralis endoscopos myotomiát [POEM]) és sebészi (laparoscopos, thoracoscopos myotomia) kezeléseket váltakozó sikerrel alkalmazunk.
A betegség progresszivitása miatt a betegek 5%-ánál a nyelésképtelenségig fokozódó dysphagia, megaoesophagus alakul ki, megoldására műtéti beavatkozás válik szükségessé. A működésképtelen nyelőcső eltávolítása és pótlása kiterjedt, nem elhanyagolható morbiditással és mortalitással járó beavatkozás. Közleményünkben egy 45 éves nőbeteg kórtörténetét, az általunk alkalmazott műtéti beavatkozást ismertetjük. A beteg a műtét óta panaszmentes.
The first oesophago-cardio-myotomy for achalasia cardiae was performed more than a hundred years ago by Ernst Heller, a German surgeon. To this day, achalasia patients entrust this intervention to end their complaints. Even today, achalasia is a chronic, progressive disease, the causative therapy of which is still unknown, symptomatic treatments include medical (calcium channel blockers, etc.), endoscopic (botulinum toxin injection, balloon dilatation, per oral endoscopic myotomy [POEM]) and surgical interventions (laparoscopic, thoracoscopic myotomy), which are applied with varying success.
Due to the progressiveness of the disease, 5% of patients develop dysphagia, megaesophagus, progressing to the inability to swallow, therefore, surgical intervention becomes necessary. Removal and replacement of the non-functional esophagus is an extensive intervention with significant morbidity and mortality. In our report, we describe the medical history of a 45-year-old female patient and the surgical intervention we applied. The patient has no complaints since the operation.
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