Predictive factors associated with the persistence of chest pain in post-laparoscopic myotomy and fundoplication in patients with achalasia
BackgroundEpisodic angina-like retrosternal pain is a prevalent symptom for achalasia patients pre- and post-treatment. The cause of postoperative chest pain remains poorly understood. Moreover, there are no reports on their predictive value for chest pain in the long-term post-treatment. The effect...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.941581/full |
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| author | Héctor Olvera-Prado José Peralta-Figueroa Sofía Narváez-Chávez Mario E. Rendón-Macías Andric Perez-Ortiz Janette Furuzawa-Carballeda Silvia Méndez-Flores María del Carmen Núñez-Pompa Alonso Trigos-Díaz Rodrigo Areán-Sanz Fidel López-Verdugo Enrique Coss-Adame Miguel A. Valdovinos Gonzalo Torres-Villalobos Gonzalo Torres-Villalobos |
| author_facet | Héctor Olvera-Prado José Peralta-Figueroa Sofía Narváez-Chávez Mario E. Rendón-Macías Andric Perez-Ortiz Janette Furuzawa-Carballeda Silvia Méndez-Flores María del Carmen Núñez-Pompa Alonso Trigos-Díaz Rodrigo Areán-Sanz Fidel López-Verdugo Enrique Coss-Adame Miguel A. Valdovinos Gonzalo Torres-Villalobos Gonzalo Torres-Villalobos |
| author_sort | Héctor Olvera-Prado |
| collection | DOAJ |
| description | BackgroundEpisodic angina-like retrosternal pain is a prevalent symptom for achalasia patients pre- and post-treatment. The cause of postoperative chest pain remains poorly understood. Moreover, there are no reports on their predictive value for chest pain in the long-term post-treatment. The effect of laparoscopic Heller myotomy (LHM) and fundoplication techniques (Dor vs. Toupet) is unclear.MethodsWe analyzed a cohort of 129 achalasia cases treated with LHM and randomly assigned fundoplication technique. All the patients were diagnosed with achalasia by high-resolution manometry (HRM). Patients were followed up at 1-, 6-, 12-, and 24-month post-treatment. We implemented unadjusted and adjusted logistic regression analyses to evaluate the predictive significance of pre- and post-operative clinical factors.ResultsPreoperative chest pain with every meal was associated with an increased risk of occasional postoperative chest pain [unadjusted model: odds ratio (OR) = 12, 95% CI: 2.2–63.9, P = 0.006; adjusted model: OR = 26, 95% CI: 2.6–259.1, P = 0.005]. In type II achalasia, hypercontraction was also associated with an increased risk of chest pain (unadjusted model: OR = 2.6 e9 in all the patients). No significant differences were associated with age, type of achalasia, dysphagia, esophageal shape, and integrated relaxation pressure (IRP) with an increased risk of occasional postoperative chest pain. Also, there was no significant difference between fundoplication techniques or surgical approaches (e.g., length of myotomy).ConclusionPreoperative chest pain with every meal was associated with a higher risk of occasionally postoperative chest pain. |
| first_indexed | 2024-04-12T13:37:11Z |
| format | Article |
| id | doaj.art-2b974e38262046a398c7b5f4c25ea34c |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-12T13:37:11Z |
| publishDate | 2022-10-01 |
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| series | Frontiers in Medicine |
| spelling | doaj.art-2b974e38262046a398c7b5f4c25ea34c2022-12-22T03:30:57ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-10-01910.3389/fmed.2022.941581941581Predictive factors associated with the persistence of chest pain in post-laparoscopic myotomy and fundoplication in patients with achalasiaHéctor Olvera-Prado0José Peralta-Figueroa1Sofía Narváez-Chávez2Mario E. Rendón-Macías3Andric Perez-Ortiz4Janette Furuzawa-Carballeda5Silvia Méndez-Flores6María del Carmen Núñez-Pompa7Alonso Trigos-Díaz8Rodrigo Areán-Sanz9Fidel López-Verdugo10Enrique Coss-Adame11Miguel A. Valdovinos12Gonzalo Torres-Villalobos13Gonzalo Torres-Villalobos14Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoEscuela de Medicina, Universidad Panamericana, Mexico City, MexicoEscuela de Medicina, Universidad Panamericana, Mexico City, MexicoDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Experimental Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoBackgroundEpisodic angina-like retrosternal pain is a prevalent symptom for achalasia patients pre- and post-treatment. The cause of postoperative chest pain remains poorly understood. Moreover, there are no reports on their predictive value for chest pain in the long-term post-treatment. The effect of laparoscopic Heller myotomy (LHM) and fundoplication techniques (Dor vs. Toupet) is unclear.MethodsWe analyzed a cohort of 129 achalasia cases treated with LHM and randomly assigned fundoplication technique. All the patients were diagnosed with achalasia by high-resolution manometry (HRM). Patients were followed up at 1-, 6-, 12-, and 24-month post-treatment. We implemented unadjusted and adjusted logistic regression analyses to evaluate the predictive significance of pre- and post-operative clinical factors.ResultsPreoperative chest pain with every meal was associated with an increased risk of occasional postoperative chest pain [unadjusted model: odds ratio (OR) = 12, 95% CI: 2.2–63.9, P = 0.006; adjusted model: OR = 26, 95% CI: 2.6–259.1, P = 0.005]. In type II achalasia, hypercontraction was also associated with an increased risk of chest pain (unadjusted model: OR = 2.6 e9 in all the patients). No significant differences were associated with age, type of achalasia, dysphagia, esophageal shape, and integrated relaxation pressure (IRP) with an increased risk of occasional postoperative chest pain. Also, there was no significant difference between fundoplication techniques or surgical approaches (e.g., length of myotomy).ConclusionPreoperative chest pain with every meal was associated with a higher risk of occasionally postoperative chest pain.https://www.frontiersin.org/articles/10.3389/fmed.2022.941581/fullachalasiachest paindysphagiapredictive factorspost-laparoscopic myotomy |
| spellingShingle | Héctor Olvera-Prado José Peralta-Figueroa Sofía Narváez-Chávez Mario E. Rendón-Macías Andric Perez-Ortiz Janette Furuzawa-Carballeda Silvia Méndez-Flores María del Carmen Núñez-Pompa Alonso Trigos-Díaz Rodrigo Areán-Sanz Fidel López-Verdugo Enrique Coss-Adame Miguel A. Valdovinos Gonzalo Torres-Villalobos Gonzalo Torres-Villalobos Predictive factors associated with the persistence of chest pain in post-laparoscopic myotomy and fundoplication in patients with achalasia Frontiers in Medicine achalasia chest pain dysphagia predictive factors post-laparoscopic myotomy |
| title | Predictive factors associated with the persistence of chest pain in post-laparoscopic myotomy and fundoplication in patients with achalasia |
| title_full | Predictive factors associated with the persistence of chest pain in post-laparoscopic myotomy and fundoplication in patients with achalasia |
| title_fullStr | Predictive factors associated with the persistence of chest pain in post-laparoscopic myotomy and fundoplication in patients with achalasia |
| title_full_unstemmed | Predictive factors associated with the persistence of chest pain in post-laparoscopic myotomy and fundoplication in patients with achalasia |
| title_short | Predictive factors associated with the persistence of chest pain in post-laparoscopic myotomy and fundoplication in patients with achalasia |
| title_sort | predictive factors associated with the persistence of chest pain in post laparoscopic myotomy and fundoplication in patients with achalasia |
| topic | achalasia chest pain dysphagia predictive factors post-laparoscopic myotomy |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.941581/full |
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