How Successful is the Surgery for Achalasia Cardia?

achalasia cardia surgery in India - CUSP Surgeons

Achalasia cardia is the degenerative motility disorder of the esophagus due to the inability of the lower esophageal sphincter to relax to the response of food bowel movement or peristalsis in the esophagus in length. Achalasia treatment surgeons in Delhi consider it as a rare neurogenerative disorder leading to impaired peristalsis and defective relaxation in the esophagus. There have been several pieces of research about achalasia cardia but an exact etiology is still unknown. With the recent advances in the medical technology, the Achalasia cardia treatment in south Delhi is drifting towards more minimally invasive procedures, the basic treatment procedure followed for achalasia cardia has been pneumatic balloon dilation and laparoscopic Heller myotomy. Recent evidence has indicated that achalasia cardio is an autoimmune process triggered by a virus.

There are researches still going on around achalasia cardio to find out its exact cause or causes. Many studies have suggested that degeneration in nerves of the esophagus leads to advanced symptoms of achalasia thus following achalasia surgery in Greater Kailash. Another cause is a rare parasitic infection known as Chagas’ disease.

People suffering from AC over the year develop great difficulty in swallowing solid as well as a liquid; adding to this, these people have a very high risk of developing esophageal cancer. Doctors rely on high-resolution esophageal topography and endoscopy.  In order to diagnose AC high-resolution manometry has replaced the conventional manometry as it helps in better detection of the esophageal pressure present. It also helps in the prediction of reoccurrence of this issue after treatment. Along with this, doctors also rely upon timed barium esophagogram in which a controlled amount of barium is ingested and films are made at predefined intervals.

Researches have provided the medical professionals with all the possible ways to manage AC however, a full cure is still unknown and constant studies are dedicated to it. Since the initial description, there has been an increase in the number of endoscopic and surgical procedures which are modified from time to time. The best treatment for piles in south Delhi is also performed using surgical procedures.  All the management procedures work towards reducing the pressure in the lower esophageal sphincter and none of them are able to get back the natural motility of the esophagus, this is due to the degeneration of the myenteric neuron present in the body. The currently developed mechanisms fail to revert back the issue. Some of the management methods used are:

1.    Botulinum toxin injection: It is one of the oldest and widely used methods of management for AC due to its safe and short term result. There is only one disadvantage associated with it, its lack of long term results which makes the patient dependent on constant treatments. Currently, botulinum toxin injection is used on a specific group of patients who are not fit for pneumatic balloon dilation or myotomy.

2.    Pneumatic Balloon Dilation: It is common on a surgical procedure for AC, in this noncompliant polyethylene balloons are used for violation of the lower esophageal sphincter. The dialation is usually started at 30 mm which is subsequently increased over time. The complication attached to it is the possibility of perforation in these balloons.

3.    Laparoscopic heller’s myotomy: It the use of Laparoscopic heller’s myotomy the motility rate decreased over time and it is a standard surgical procedure followed today for AC. It is combined with partial posterior or anterior fundoplication to limit gastroesophageal reflux and the occurrence of repetitive dysphagia.

4.    POEM Technique: It is a methodology used under general anesthesia. In this, a mucosal incision is made to make a mucosal tunnel. After this treatment, the patients are not allowed to eat for 24 hours after which oral liquids are started.

The success rate of these techniques are good however there is a lack of long term continuation. Its result stays for short term or mid-term. A single balloon dilation surgery continues to alleviate symptoms of achalasia cardia in about 60 percent of people in a year after the process and about 25 percent of people five years post-procedure.

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