Raj kumar, J (2015) Achalasia cardia – An observational study on histopathological, ultrastructural, manometric features and analysis of short term surgical outcomes after laparoscopic Heller’s myotomy. Masters thesis, Christian Medical College, Vellore.
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Abstract
Achalasia cardia is a motility disorder affecting the esophagus with loss of progressive peristalsis and deglutitive relaxation of the lower esophageal sphincter. The pathogenesis of the disease and its etiology is poorly understood. Laparoscopic Heller’s myotomy, pneumatic balloon dilatation of the lower esophageal sphincter and intra-esophageal injection of botulinum toxin are some of the treatment modalities available. Type of study: Prospective observational study Methodology: Twenty one patients who underwent laparoscopic Heller’s myotomy were recruited for the study. Biopsy of the lower esophageal muscle was obtained and histopathological, immunohistochemical and ultrastructural analysis was performed. It was correlated with the clinical features, manometric features and post-operative outcomes. Conclusion: Achalasia cardia is an inflammatory disease of the myentric plexus with early onset of fibrosis and progressive neuronal degeneration affecting myelinated and non-myelinated neurons. Degree of fibrosis increases with the duration of illness. Degree of fibrosis of the lower esophageal sphincter or degree of inflammation in the myentric plexus did not affect the manometric features of dysphagia or post-operative outcomes. Selective inhibition of the inhibitory neurons and inciting factors are the facets of the disease which still remains an enigma.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Achalasia cardia; Histopathological; Ultrastructural; Manometric; Laparoscopic Heller’s myotomy |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Punitha K |
| Date Deposited: | 31 Jul 2017 10:19 |
| Last Modified: | 28 Sep 2017 03:12 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2395 |
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