Skip to main content

Advertisement

SpringerLink
Log in

The patient characteristics of esophageal carcinoma following laparoscopic myotomy for esophageal achalasia

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

It is common knowledge that esophageal achalasia patients have a high risk of developing esophageal carcinoma. The present study assessed the characteristics of esophageal carcinoma patients following laparoscopic Heller-Dor surgery (LHD) for esophageal achalasia.

Method

Among 622 cases which were esophageal achalasia patients and underwent LHD as the primary surgery, we compared the patient background, pathophysiology, symptoms, and surgical outcomes according to whether or not esophageal carcinoma occurred following surgery.

Results

Six cases (0.96%) of postoperative esophageal carcinoma were confirmed. The characteristics of the cases in which esophageal carcinoma occurred were older age, longer disease duration (p = 0.0362 and 0.0028, respectively), decreased sphincter pressure of the lower esophagus, a high rate of sigmoid esophagus, and a long esophagus lateral diameter (p = 0.0214, 0.001, and 0.0416, respectively). Moreover, no differences in surgical outcomes were confirmed and there were no differences in symptoms from before and following surgery.

Conclusion

The characteristics of esophageal carcinoma patients with achalasia following laparoscopic myotomy were an older age, longer disease duration, and greater progression of disease pathophysiology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Furuzawa-Carballeda J, Torres-Landa S, Valdovinos MA, Coss-Adame E, Martin Del Campo LA, Torres-Villalobos G (2016) New insights into the pathophysiology of achalasia and implications for future treatment. World J Gastroenterol 22:7892–7907

    Article  CAS  Google Scholar 

  2. Schlottmann F, Patti MG (2018) Esophageal achalasia: current diagnosis and treatment. Expert Rev Gastroenterol Hepatol 12:711–721

    Article  CAS  Google Scholar 

  3. Facciorusso A, Singh S, Abbas Fehmi SM, Annese V, Lipham J, Yadlapati R (2020) Comparative efficacy of first-line therapeutic interventions for achalasia: a systematic review and network meta-analysis. Surg Endosc. https://doi.org/10.1007/s00464-020-07920-x

    Article  PubMed  PubMed Central  Google Scholar 

  4. Pandolfino JE, Gawron AJ (2015) Achalasia: a systematic review. JAMA 313:1841–1852

    Article  Google Scholar 

  5. Tsuboi K, Omura N, Yano F, Hoshino M, Yamamoto SR, Akimoto S, Masuda T, Kashiwagi H, Yanaga K (2020) Therapeutic efficacy of laparoscopic Helle-Dor surgery for chest pain in patients with achalasia: a single institutional experience. Esophagus 2020(17):197–207

    Article  Google Scholar 

  6. Japan esophageal society (2017) Descriptive Rules for Achalasia of the Esophagus, June 2012: 4th edition. Esophagus 14:275–289

    Article  Google Scholar 

  7. Yadlapati R, Kahrilas PJ, Fox MR, Bredenoord AJ, Prakash Gyawali C, Roman S et al (2021) Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0. Neurogastroenterol Motil 33(1):e14058. https://doi.org/10.1111/nmo.14058

    Article  PubMed  PubMed Central  Google Scholar 

  8. de Olivaira JM, Birgisson S, Doinoff C, Einstein D, Herts B, Davros W, Obuchowski N, Koehler RE, Richter J, Baker ME (1997) Timed barium swallow: a simple technique for evaluating esophageal emptying in patients with achalasia. AJR Am J Roentgenol 169:473–479

    Article  Google Scholar 

  9. Reynolds JC, Parkman HP (1989) Achalasia. Gastroenterol Clin North Am 18:223–255

    Article  CAS  Google Scholar 

  10. Spiess AE, Kahrilas PJ (1998) Treating achalasia: from whalebone to laparoscope. JAMA 280:638–642

    Article  CAS  Google Scholar 

  11. Sandler RS, Nyren O, Ekbom A, Eisen GM, Yuen J, Josefsson S (1995) The risk of esophageal cancer in patients with achalasia. JAMA 274:1359–1362

    Article  CAS  Google Scholar 

  12. Boeckxstaens GE, Zaninotto G, Richter JE (2014) Achalasia Lancet 383:83–93

    Article  Google Scholar 

  13. Gillies CL, Farrukh A, Abrams KR, Mayberry JF (2019) Risk of esophageal cancer in achalasia cardia: a meta-analysis. JGH Open 3:196–200

    Article  Google Scholar 

  14. Fagge CH (1872) A case of simple stenosis of the esophagus followed by epithelioma. Guys Hosp Rep 17:413–421

    Google Scholar 

  15. Ravi K, Geno DM, Katzka DA (2015) Esophageal cancer screening in achalasia: is there a consensus? Dis Esophagus 28:299–304

    Article  CAS  Google Scholar 

  16. Gong EJ, Kim DH (2018) Retention esophagitis in patients with achalasia requires cancer surveillance. Clin Endosc 51:111–112

    Article  Google Scholar 

  17. Loviscek LF, Cenoz MC, Badaloni AE, Agarinakazato O (1998) Early cancer in achalasia. Dis Esophagus 11:239–247

    Article  CAS  Google Scholar 

  18. Nesteruk K, Spaander MCW, Leeuwenburgh I, Peppelenbosch MP, Fuhler GM (2019) Achalasia and associated esophageal cancer risk: what lessons can we learn from the molecular analysis if Barrett’s-associated adenocarcinoma? Biochim Biophys Acta Rev Cancer 1872:188291. https://doi.org/10.1016/j.bbcan.2019.04.007

    Article  CAS  PubMed  Google Scholar 

  19. Tustumi F, Bernardo WM, da Rocha JRM, Szachnowicz S, Seguro FC, Bianchi ET, Sallum RAA, Cecconello I (2017) Esophageal achalasia: a risk factor for carcinoma. A systematic review and meta-analysis. Dis Esophagus 30:1–8

    Article  CAS  Google Scholar 

  20. Fujii T, Yamana H, Sueyoshi S, Fujita H, Tanaka Y, Kubota M, Toh U, Mine T, Sasahara H, Shirouzu K, Kato S, Morimatsu M (2000) Histopathological analysus of non-malignant and malignant epithelium in achalasia of the esophagus. Dis Esophagus 13:110–116

    Article  CAS  Google Scholar 

  21. Leeuwenburgh I, Gerrits MM, Capello A, van den Bogert B, van Dekken H, Steyerberg EW, Siersema PD, Kuipers EJ (2010) Expression of p53 as predictor for the development of esophageal cancer in achalasia patients. Dis Esophagus 23:506–511

    Article  CAS  Google Scholar 

  22. Zaninotto G, Rizzetto C, Zambon P, Guzzinati S, Finotti E, Costantini M (2008) Long-term outcome and risk of oesophageal cancer after surgery for achalasia. Br J Surg 95:1488–1494

    Article  CAS  Google Scholar 

  23. Sato H, Yokomichi H, Takahashi K, Tominaga K, Mizusawa T, Kimura N, Kawata Y, Terai S (2019) Epidemiological analysis of achalasia in Japan using a large-scale claims database. J Gastroenterol 54:621–627

    Article  Google Scholar 

  24. Markar SR, Wiggins T, MacKenzie H, Faiz O, Zaninotto G, Hanna GB (2019) Incidence and risk factors for esophageal cancer following achalasia treatment: national population-based case-control study. Dis Esophagus 32:1–7

    PubMed  Google Scholar 

  25. Leeuwenburgh I, Scholten P, Alderliesten J, Tilanus HW, Looman CWN, Steijerberg EW, Kuipers EJ (2010) Long-term esophageal cancer risk in patients with primary achalasia: a prospective study. Am J Gastroenterol 105:2144–2149

    Article  CAS  Google Scholar 

  26. Brucher BL, Stein HJ, Bartels H, Feussner H, Siewert JR (2001) Achalasia and esophageal cancer: incidence, prevalence, and prognosis. World J Surg 25:745–749

    Article  CAS  Google Scholar 

  27. Zagari RM, Marasco G, Tassi V, Ferretti S, Lugaresi M, Fortunato F, Bazzoli F, Mattioli S (2021) Risk of squamous cell carcinoma and adenocarcinoma of the esophagus in patients with achalasia: a long-term prospective cohort study in Italy. Am J Gastorneterol 116:289–295

    Article  Google Scholar 

  28. Vaezi MF, Pandlfino JE, Vela MF (2013) ACG clinical guideline: diagnosis and management of achalasia. Am J Gastroenterol 108:1238–1249

    Article  Google Scholar 

  29. Fukushima N, Masuda T, Yano F, Omura N, Tsuboi K, Hoshino M, Yamamoto SR, Akimoto S, Sakashita Y, Mitsumori N, Kashiwagi H, Ikegami T (2020) Over ten-year outcomes of laparoscopic Heller-myotomy with Dor-fundoplication with achalasia: single-center experience with annual endoscopic surveillance. Surg Endosc. https://doi.org/10.1007/s00464-020-08148-5

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Fuji City General Hospital, 50, Takashima-cho, Fuji, Shizuoka, 416-0951, Japan

    Kazuto Tsuboi & Hideyuki Kashiwagi

  2. Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan

    Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Yuki Sakashita & Naoko Fukushima

  3. Department of Surgery, Nishisaitama-Chuo National Hospital, Tokorozawa, Japan

    Nobuo Omura

Authors
  1. Kazuto Tsuboi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nobuo Omura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fumiaki Yano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masato Hoshino
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Se-Ryung Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shunsuke Akimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takahiro Masuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yuki Sakashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Naoko Fukushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hideyuki Kashiwagi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study conception and design-Tsuboi, Omura, Yano. Acquisition of data-Tsuboi, Omura, Yano, Hoshino, Yamamoto, Akimoto, Masuda, Sakashita, Fukushima, Kashiwagi. Analysis and interpretation of data-Tsuboi, Omura, Yano. Drafting of manuscript-Tsuboi, Omura. Critical revision of manuscript-Tsuboi, Omura.

Corresponding author

Correspondence to Kazuto Tsuboi.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare no conflict of interest.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tsuboi, K., Omura, N., Yano, F. et al. The patient characteristics of esophageal carcinoma following laparoscopic myotomy for esophageal achalasia. Langenbecks Arch Surg 406, 2679–2686 (2021). https://doi.org/10.1007/s00423-021-02270-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-021-02270-1

Keywords

Search

Navigation