Long‐term outcomes after esophagectomy for end‐stage achalasia: A bridge to a better quality of life?

Abstract

AbstractObjectiveWe sought to evaluate the outcomes of patients with end‐stage achalasia (ESA) who underwent esophagectomy.MethodsAll patients who underwent esophagectomy for ESA and replied to a QoL‐centred questionnaire from 2002 to 2015 were included.ResultsOverall, 14 patients underwent esophagectomy for ESA, 12 (85.7%) patients completed the questionnaire and were included in the study. Patients were referred for esophagectomy after 18.5 median years (IQR1‐3 13.5–35.25) since presentation of symptoms. Heller's myotomy was previously performed in eight patients (66.7%). Major postoperative complications occurred in 2 (16.7%) patients. No patients required reoperation, and there was no postoperative mortality. At a median follow‐up of 84 months (IQR1‐3 60–84 months), satisfaction in postoperative symptom control was reported in 10 (83.3%) patients. Patients reported significant improvements in frequency of dysphagia (p < .001), regurgitation (p = .004), heartburn (p = .034), cough (p = .003), and odynophagia (p = .001). Specifically, incidence of dysphagia for liquid food was reduced from 100% to 16.7% (p < .001), for semisolid food from 81.8% to 16.7% (p = .003), and for solid food from 100% to 41.7% (p = .005).ConclusionsIn select patients suffering from long‐standing ESA, esophagectomy is feasible and is associated with good perioperative and long‐term outcomes.