2007, Number 4
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ABSTRACTObjective: To report the results obtained with the surgical treatment of cervical esophageal motor disorders.
Setting: Third level health care hospital.
Design: Retrospective and observational.
Statistical analysis: Percentages as summary measure for qualitative variables.
Patients and methods: In a 22-year period, 43 patients with oropharyngeal dysphagia, who had not responded to diverse types of conservative treatment, were operated. Two groups were formed according to the presence or absence of diverticula, analyzing demographic characteristics, clinical alterations, diagnostic methods, diverse technical aspects of the treatment, surgical morbidity and mortality, as well as the results.
Results: A slight predominance of the male gender was encountered; average age was of 67 years. All patients referred high dysphagia, which was progressive in most, accompanied by regurgitations and weight loss. Imagining studies were the most useful and more than two-thirds of the patients presented diverticula. All were subjected to cricopharyngeal myotomy and, depending on the characteristics of the diverticulum, either diverticulectomy or diverticulopexy were performed. Six (14%) esophageal fistulas were documented, which closed in a maximum of 4 weeks. No deaths occurred. Symptoms improved in 86% from the first weeks on, and this increased in 10% at a longer term, predominating in those patients with diverticula.
Conclusions: Surgical treatment of cervical esophageal motor disorders is more effective in those patients that develop pharyngoesophageal diverticulum than in those lacking it.
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