Surgery of the recurrent dysphagia after prior operations for cardiospasm

Introduction: The problem of surgical treatment of cardiospasm still represents a complicated challenge. It is even more complicated by the fact that a number of surgeons keep using an operative method as fundamental without even making cardiodilatation attempts. Materials and methods: 32 patients with relapse of dysphagia after previous operations for cardiospasm aging from 28 to 75 were treated in the department of oesophagus and stomach surgery. There were 12 men and 20 women. A strong cicatrical stricture of cardioesophageal transition and the lower third of thoracic section of oesophagus has been diagnosed in 3 patients. Different stages of cardiospasm has been diagnosed in 29 patients, of which in 9 patients – II stage, in 15 patients – III stage and in 5 patients – IV stage. Results and discussions: The following variants of treatment have been performed by us: 1. Conservative treatment has been performed in 5 patients. 2. Bougienage of the esophagus has been performed in 4 patients. It was only possible treatment method in patients of this category. 3. Cardiodilatation has been performed in 18 patients: pneumatic one in 17 patients and the one with Shtark apparatus in 1 patient. In 3 patients cardiodilatation was complicated by erosive esophagitis, which has been liquidated by conservative measures. There haven’t been other complications. Results were as follows: good –in 7 patients, satisfactory– in 10 patients and unsatisfactory in 1 patient. 4. Surgical treatment has been performed in 5 patients. Indications for surgery treatment were ineffectiveness of bougienage or cardiodilatation and also the impossibility of conducting the bougie or dilator through cicatrically narrowed cardia.

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