Re: More on dilatation (and Resection)

[Guest guest]

Rich wrote:

> My point in all this is that dilitation is an option for treatment and relief

of symptoms for those not willing to entertain myotomy or those desiring a more

conservative approach. Those inclined to tolerate symptoms, " tough it out " , or

" wait for a cure " (and I include myself in this group) might find it worthwhile

to consider this treatment sooner than later.

That is a good point.

> I delayed treatment (dilitation) for a few years after my initial diagnosis.

No one has told me that this is the cause, but over the years my esophagus has

become quite enlarged and near-sigmoid in shape.

There are no guarantees. You could have gotten treatment and still ended

up as you are, but there will always be that chance that it would have

made a difference.

> Fortunately myotomy is still an option for me but this will require the added

step of 'pulling down and straightening' my esophagus (re-section).

I sometimes see the term " resection " used differently in this support

group than the way I understand it. To me resection means removal of a

part or all of an organ or tissue. So, when referring to esophageal

resection it means the same to me as esophagectomy, which is the removal

of a part or all of the esophagus. Either of these terms can be combined

with " total " , " subtotal " or " partial " . Sometimes in studies you will see

both terms used for the same group of patients. There may be a statement

something like, for the 9 patients requiring resection esophagectomy was

successful in 8. (I made that up). In this case resection is the need

and esophagectomy is the way that need is fulfilled.

The LES is also known as the cardiac sphincter. That is why the myotomy

is sometimes called cardiomyotomy or heller cardiomyotomy. There is also

a resection of the LES known as cadia resection which is the removal of

a part or all of the LES. (Not to be confused with various types of

Cardioplasty that can be done that may require some cardia resection.)

For the esophagus you may also see " proximal " or " distal " used with

resection or esophagectomy which tells which end of the esophagus the

resection was at. For achalasia a distal, if not nearly total

,resection/esophagectomy would be done.

So, If your doctor talks about doing a resection, ask him what he

intends to resect and how much of it. If he says it would be an

esophagectomy ask him if it will total or subtotal. If he says

Cardioplasty, just say what and look confused. Get him to explain that

one, but basically, it means he is going to in some way remake the LES.

It could simply mean " straighten " or much more.

notan