Re: Re: and Steve and Esophagectomy Group

[Guest guest]

Hi Dayna,

Again my thanks goes out to Maggie for sharing this article with me. We all help each other so we all benefit. As you know the article was not written for the general public. Its unfortunate that parts of it are beyond our understanding (including mine). I'm copying it below with the grandiose plan of translating the "medical speak" into English (notations in red).

Abstract Advanced end-stage achalasia was treated by esophagus-preserving surgery in four women. Their median age was 46.5 years, and the median duration of symptoms was 17.0 years. Advanced end-stage achalasia was defined as esophageal dilatation to more than 6cm in diameter and meandering (winding, bending, curving esophagus) on radiography.

Myotomy (surgical division of a muscle), fundopexy (anti-reflux

procedure following a Heller Myotomy), and posterior fixation (not 100%

positive on describing this, but a procedure involved with straightening

the lower esophagus) with straightening of the lower esophagus were

performed. Myotomy was carried out for 5cm in the esophagus and 2cm

in the stomach. The outcome of surgery was evaluated by Paynes

criteria and esophageal manometry. Laparotomy (a procedure in which a

surgeon makes an incision in the lower abdomen in order to inspect the

abdominal cavity at which time he can correct structural problems) was

performed in three patients and left thoracotomy (a surgical procedure

for opening the left chest wall in order to access the lungs, esophagus,

trachea, aorta, heart and diaphragm) plus laparotomy was done in one

patient. The outcome of surgery was good to excellent in all cases by Paynes criteria, and postoperative esophageal manometry showed a longer lower esophageal sphincter (LES) and lowered lower esophageal sphincter pressure (LESP). Preservation of the esophagus should be attempted before performing esophagectomy for advanced achalasia."

So 3 patients just had the laparotomy, while one patient had the laparotomy and the left thoracotomy. It appears these procedures were done to check out the territory. "Paynes criteria" must be some kind of standardized evaluation scale for the condition and/or functioning of the esophagus in this case.

Definition of the suffix "-otomy" or "-tomy" is: that it is an act of cutting, or an incision, and the part of the word preceding the (suffix "otomy") indicates where, on or in the body, the cutting is taking place.

In a message dated 10/5/2006 9:55:33 P.M. Eastern Standard Time, dayna@... writes:

This is very hopeful! I get the general idea, but I don't understand the medical lingo specifically detailing what procedure was done. Especially: "Laparotomy was performed in three patients and left thoracotomy plus laparotomy was done in one patient.", are you able to explain in non-medical terms a little??Thanks. Dayna>> > ,> > Thank you for an excellent post, and Steve, of course for your well > founded concerns. Now, I'm going to throw in another factor, that Steve, I hope > does not upset you, but I find myself forced to come forward rather than > withhold.> > I give my dearest Maggie credit for sending me this link. It fits into > my plans, possibly 's and Steve, you are so close, but not yet wearing > the hospital gown. > > Here is the link. The report came out of Japan, but the surgery does > not have to be there.> > > > > _SpringerLink - Journal Article_ > (http://springerlink.com/content/l6pr9284l77547gh/) > > > Abstract Advanced end-stage achalasia was treated by esophagus-preserving > surgery in four women. Their median age was 46.5 years, and the median > duration of symptoms was 17.0 years. Advanced end-stage achalasia was defined as > esophageal dilatation to more than 6cm in diameter and meandering on radiography. > Myotomy, fundopexy, and posterior fixation with straightening of the lower > esophagus were performed. Myotomy was carried out for 5cm in the esophagus and > 2cm in the stomach. The outcome of surgery was evaluated by Paynes criteria > and esophageal manometry. Laparotomy was performed in three patients and left > thoracotomy plus laparotomy was done in one patient. The outcome of surgery > was good to excellent in all cases by Paynes criteria, and postoperative > esophageal manometry showed a longer lower esophageal sphincter (LES) and lowered > lower esophageal sphincter pressure (LESP). Preservation of the esophagus > should be attempted before performing esophagectomy for advanced achalasia.> > ____________________________________> Masaho Ota> Email: _masaho@..._ (mailto:masaho@...) > Phone: +81-3-3823-2101> Fax: +81-3-3824-1552> > > In a message dated 10/5/2006 8:49:15 P.M. Eastern Standard Time, > tracylb@... writes:> > > > > > Steve, > As another member of our esophagectomy group, I certainly don’t think that > our postings should cause distress to others, but rather educate them on what > could potentially be their future. I don’t mean that to sound cruel, but if I > had know 16 years ago what I know now, I may not be facing this major > decision right now. > Granted, that will never be known, and even if I had the proper treatment > all these years and the necessary regular follow up I could still be in this > position. > However, I think all of our talk about the esophagectomy and different > doctors we have dealt with and how we got to where we are is all very valuable > information that should be shared with the rest of the group. I like to think of > our misfortune with this disease/disorder/However, I think all of our talk > about the esophagectomy and different doctors we have dealt with and how we > got to where we are is all very valuable information that should be shared > with the rest of the group. I like to think of our misfortune with this > disease/disorder/<WBR>condition (notice me covering my bases on that one > in NY > > > ____________________________________> > From: <ST1>achalasia [mailto: [mailto:<ST1>a [] On Behalf Of Steve > Lennox> Sent: Thursday, Thursday, <ST1>Octo <ST1>5> <ST1>achalasia > Subject: Re: Re: back from Esophagectomy> > > > > > Deborah,> > > > Impossible to answer. You are quite right, many (most) live a full life > never needing the oesophagectomy. The majority of people on this board for > example. > > > > I often wonder if my postings cause distress to others who may not want to > hear the end stage stories and I did post this question back some time ago and > suggested us oesophagectomy people clearly label our postings so that people > can skip over them. I think most of our postings do have that in the title. > I am sorry if we have given you some extra worries. I do wonder if in > seeking help from others I have actually caused distress to others too. > Apologies if this is the case. But I think in all honesty I would have liked to have > known this could happen right from the start. I only found this group in > february and I only found out that Achalasia could result in an oesophagectomy > in March. > > > > All the best> > > > STEVE> > Re: back from Esophagectomy > > > Dear Steve and Mike,> > > > This Ectomy thingie is beginning to get into my brain, so, I've got> > a question for you, for everyone here:> > > > How many years are the norm. between having a Heller's and> > having a Esophagectomy? > > > > Big question, and, prob. many answers, including the idea that> > not everyone will proceed right up to the Ectomy. But, for you two> > gents, would you mind refreshing me on this one?> > > > Oh, my. I am glad that you are both getting better but I am> > also sending sympathies over the surgeries and the recuperation times,> > etc.> > The only other thing I want to say is, I'M GLAD ICE CREAM IS> > A SOFT FOOD.> > > > all best, Deborah> > > > > > > ____________________________________> > _All new _ > (http://us.rd./mail/uk/taglines/default/nowyoucan/pc_mag/*http:/us.rd./evt=40565/*http:/uk.docs./nowyoucan> .html) "The new Interface is stunning in its simplicity and ease of use." - > PC Magazine>