: Serra-Dória procedure for reoperation of

[Guest guest]

:

Here is an odd one. I am too tired to read it all right now, but it

looks interesting. Very technical. You may have to go to South America

for it. They of course have lots of megaesophagi because of Chagas'.

Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure)

for reoperation of achalasia

http://www.scielo.br/scielo.php?pid=S0004-28032004000300004 & script=sci_arttext

notan

[Guest guest]

Notan,

Your amazing, digging up these references that apply to us! The operation is right on the money.

"the Serra-Dória procedure" might go by other names in other countries and have variations as to the techniques used.

In the test group in the article I easily fit into group IV.

"group IV - significant dilatation of the esophagus, with axis turned to the right over the diaphragm (dolichomegaesophagus), prolonged retention of barium, with difficult barium entrance into the stomach."

The test group consisted of:

"Twenty patients with achalasia due to Chagas’ disease, who had previously undergone cardiomyotomy with or without fundoplication were studied."

This does not mean that people with primary achalasia would not benefit from this operation. It was just the test sample they chose for this study.

The article is quite lengthy, and I am saving it for future reference. In some places it reads like a history lesson, going back over a hundred years to when it first started being used and how it basically was replaced with the Heller surgery in 1913.

"Historically, the treatment of achalasia by cardiomyotomy was first designed by GOTTSTEIN(27), in 1901. However, HELLER(30), in 1913, acclaimed the procedure by performing it in the anterior and posterior esophageal walls."

"Thus, it was observed that the Serra-Dória operation(58, 59), can be easily performed, with low morbidity and mortality. It yielded important relief from symptoms, specially from dysphagia, and in most instances, a reduction of esophageal caliber. There was also improvement of reflux esophagitis. Yet, it is possible the occurrence of reflux in patients who did not present it before."

"Because it yields good results in terms of symptoms relief, it can be accredited as viable alternative for treating patients with failed cardiomyotomy for the treatment of achalasia. Further studies, with longer follow-up terms, are required in order to reach more definitive conclusions, in special as to the occurrence of later complications not identified in the present study."

I don't know how I would feel going to Brazil to have this done, but if the day comes that I must have this surgery, I would show it to Dr. Dempsey who appears to have an open mind, and knowledge of this surgery right now.

In the reference (bibliography) section at the end is the following at #43.

Two of our favorites, Dr, Patti and Pellegrini!

"43. Patti MG, Pellegrini CA, Arcerito M, Tong J, Mulvihill SJ, Way LW. Comparison of medical and minimally invasive surgical therapy for primary esophageal motility disorders. Arch Surg 1995;130:606-16."

Thanks Notan for finding this article, which was published as recently as July 3, 2004. I'm planning on forwarding it to Dr. Dempsey for his comments.

In a message dated 8/24/2006 2:51:27 A.M. Eastern Standard Time, notan_ostrich@... writes:

:Here is an odd one. I am too tired to read it all right now, but it looks interesting. Very technical. You may have to go to South America for it. They of course have lots of megaesophagi because of Chagas'.Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasiahttp://www.scielo.br/scielo.php?pid=S0004-28032004000300004 & script=sci_arttextnotan

[Guest guest]

Hello cynmark24@...,

In reference to your comment:

In the reference (bibliography) section at the end is the following at #43. Two of our favorites, Dr, Patti and Pellegrini!

, I'd bet you could email these doctors and

get some feedback.BTW, I called Un of Washington

and verified that Dr. Pellegrini is still there.

Others should read this article as well. It list some

things that cause failed myotomies that I found

interesting as well. If nothing else it proves we

should seek out doctors who are experienced in

achalasia and have done many to have this surgery.

Maggie

Alabama

[Guest guest]

Maggie,

Thanks for the correction on Dr. Pellegrini. It was a fascinating article that Notan provided us. He never ceases to amaze me as to his finding articles appropriate for even the rarest of cases.

The history of dealing with achalasia, in spite of its rarity, is very interesting, and obviously still developing. Can't wait for those stem cells!

In a message dated 8/24/2006 9:09:24 A.M. Eastern Daylight Time, LunaIam2@... writes:

In reference to your comment:

In the reference (bibliography) section at the end is the following at #43. Two of our favorites, Dr, Patti and Pellegrini!

, I'd bet you could email these doctors and

get some feedback.BTW, I called Un of Washington

and verified that Dr. Pellegrini is still there.

Others should read this article as well. It list some

things that cause failed myotomies that I found

interesting as well. If nothing else it proves we

should seek out doctors who are experienced in

achalasia and have done many to have this surgery.

Maggie

Alabama