Surgical therapy of XXXX .

@entity1 @entity1318 @entity5 @entity2910 @entity7261 @entity338 @entity357 @entity1208 @entity74 @entity158 @entity1282 @entity86 @entity2909
BACKGROUND: Surgical enucleation is the treatment of choice in selected @entity1 with @entity2910 . The video-thoracoscopic approach can potentially cause less @entity1 discomfort postoperatively and reduce the hospital stay and recovery period. STUDY DESIGN: A retrospective evaluation of 66 @entity1 who underwent surgical therapy for @entity2910 over a 27-year period was done. The main symptoms were @entity1282 in 35 (53 percent) @entity1 , @entity338 , or both, in 11 (17 percent) @entity1 , and @entity158 in ten (15 percent) @entity1 . Associated @entity1208 were found in 19 @entity1 (some @entity1 had @entity74 ): @entity357 in 15 (23 percent), @entity7261 in four (6 percent), and @entity1318 in three (5 percent). The operation consisted of @entity2909 enucleation in 63 @entity1 , and esophageal resection in three. In six @entity1 , the enucleation was successfully performed by video-thoracoscopy combined with intraoperative esophagoscopy. The muscle layer of the esophagus was approximated in the majority of the @entity1 after @entity5 enucleation. RESULTS: There was no operative mortality. The incidence of intraoperative esophageal perforation was greater in @entity1 who had previously undergone endoscopic biopsy (p < 0.01). In one @entity1 , a pseudodiverticulum developed after thoracoscopic enucleation, requiring reoperation with approximation of the muscle layer for relief of @entity1282 . The length of hospital stay was shorter in @entity1 undergoing the video-assisted operation (p < 0.05). The median follow-up period was 53 months (range, 12 to 248 months). No recurrence of @entity2909 was observed. Overall, seven (11 percent) @entity1 complained of heartburn or @entity158 , or both, which was responsive to antisecretory drugs, but only three had such symptoms induced by the operation. In two @entity1 the symptoms appeared after combined treatment of an @entity7261 , and in one @entity1 after simple @entity2909 enucleation. CONCLUSIONS: Enucleation of @entity2910 is a safe and effective operation. The video-thoracoscopic approach combined with intraoperative esophagoscopy allows performance of this procedure with the added advantage of shortening hospital stay. The muscle layer of the esophagus should be approximated to avoid decreasing the propulsive activity of the esophageal body. This may improve the long-term outcome of the operation by preserving the acid-clearing mechanism of the esophagus and reducing the incidence of @entity86 .
