Morbid Obesity with Achalasia: A Surgical Challenge

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• 作者：Monika E. Hagen (1) (2)
  Micheal Sedrak (1)
  Oliver J. Wagner (1)
  Garth Jacobsen (1)
  Mark Talamini (1)
  Santiago Horgan (1)
  
• 关键词：Obesity ; Achalasia ; Myotomy ; Gastric sleeve resection ; Robotic surgery
• 刊名：Obesity Surgery
• 出版年：2010
• 出版时间：October 2010
• 年：2010
• 卷：20
• 期：10
• 页码：1456-1458
• 全文大小：114KB
• 参考文献：1. Dughera L, Cassolino P, Cisarò F, et al. Achalasia. Minerva Gastroenterol Dietol. 2008;54(3):277-5.
  2. Pohl D, Tutuian R. Achalasia: an overview of diagnosis and treatment. J Gastrointest Liver Dis. 2007;16(3):297-03.
  3. Eckardt AJ, Eckardt VF. Current clinical approach to achalasia. World J Gastroenterol. 2009;15(32):3969-5. CrossRef
  4. Jaunoo SS, Southall PJ. Bariatric surgery. Int J Surg 2010;8(2): 86-. Epub 2009 Dec 16.
  5. O’Rourke RW, Jobe BA, Spight DH, et al. Simultaneous surgical management of achalasia and morbid obesity. Obes Surg. 2007;17(4):547-. CrossRef
  6. Kaufman JA, Pellegrini CA, Oelschlager BK. Laparoscopic Heller myotomy and Roux-en-Y gastric bypass: a novel operation for the obese patient with achalasia. J Laparoendosc Adv Surg Tech A. 2005;15(4):391-. CrossRef
  7. Jomni T, Dray X, Merrouche M, et al. Achalasia in an obese woman treated by laparoscopic gastric banding. Gastroenterol Clin Biol. 2008;32(11):973-. Epub 2008 Oct 22. CrossRef
  8. Campos GM, Vittinghoff E, Rabl C, et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg. 2009;249(1):45-7. CrossRef
  9. Horgan S, Galvani C, Gorodner MV, et al. Robotic-assisted Heller myotomy versus laparoscopic Heller myotomy for the treatment of esophageal achalasia: multicenter study. J Gastrointest Surg. 2005;9(8):1020-. CrossRef
  10. Arias E, Martinez PR, Ka ML, et al. Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obes Surg. 2009;19(5):544-. CrossRef
  
• 作者单位：Monika E. Hagen (1) (2)
  Micheal Sedrak (1)
  Oliver J. Wagner (1)
  Garth Jacobsen (1)
  Mark Talamini (1)
  Santiago Horgan (1)
  
  1. Center for the Future of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, San Diego, CA, USA
  2. Center for the Future of Surgery, Department of Surgery, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92108, USA
  

文摘

Achalasia is a relatively rare medical condition that is classically not associated with obesity. The surgical treatment of a simultaneous occurrence of these two diseases requires careful consideration, and only a few reports can be found in the literature combining a Heller myotomy with gastric bypass, duodenal switch, or gastric banding. We report the case of a 69-year-old female patient with early achalasia and obesity who underwent simultaneous laparoscopic gastric sleeve resection and robotic Heller myotomy. No intra- or postoperative complications occurred. A follow-up at 6?weeks showed a significant weight loss and resolved symptoms of achalasia. The case illustrates that a simultaneous gastric sleeve resection and robotic Heller myotomy might be an option for the treatment of concurrent obesity and achalasia.