COMMENTARY

Does Surgery for Achalasia Increase the Risk for Esophageal Cancer?

Albert B. Lowenfels, MD

Disclosures

January 28, 2009

Long-term Outcome and Risk of Oesophageal Cancer After Surgery for Achalasia

Zaninotto G, Rizzetto C, Zambon P, et al
Br J Surg. 2008;95:1488-1494

Long-term Outcome and Risk of Oesophageal Cancer After Surgery for Achalasia

What are the long-term results after an operation for esophageal achalasia? How great is the risk for esophageal cancer? The authors studied 228 patients who had a myotomy procedure after 3 years of symptoms. Median follow-up at 18.3 years was possible for 99% of patients, revealing that 5 patients needed additional surgery and 4 developed squamous esophageal cancer. The overall mortality rate was the same as expected in the background population, but there was a significant excess of esophageal cancer in males (P = .016).

Achalasia is an uncommon esophageal disorder, so it has been difficult to obtain long-term follow-up data. The results in this series were generally excellent, although reflux occurred in about 15% of patients. Apart from the observed excess of squamous cell esophageal carcinoma in males, survival was the same as in patients without achalasia.

Abstract

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