Cardioplasty for end-stage achalasia: Part 1

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Dear ISDE, AUGIS or AEC member:

We are circulating a brief questionnaire on the use of “cardioplasty” in the treatment of “End Stage Achalasia”.
This first part of the survey will take approximately five minutes to complete. Following that, those who are interested and have performed this operation will be asked to complete a second more detailed questionnaire.
Please find below a short summary of the project.

With many thanks for your participation,

Alberto Isla, Fatima Senra, Ismael Diaz del Val, Salvador Morales, Giovanni Zaninotto, Sheraz Markar.

Summary:

Background: Primary achalasia is a rare oesophageal motor disorder characterized by the absence of swallow-induced relaxation of the lower oesophageal sphincter and of peristalsis along the oesophageal body. Around 5% of these patients will develop end-stage achalasia, a situation where the oesophagus is non-functional and massively dilated, adopting a sigmoid shape. Treatment of end-stage achalasia is a challenging situation. Oesophagectomy is advocated in some of these patients, with significant morbidity and mortality. Cardioplasty is a safe alternative to oesophagectomy in end – stage achalasia. The creation of an oesophago – gastrostomy allows an appropriate oesophageal emptying even in the presence of poor motility.  

Methods: This study comprises an international survey and a multicentric retrospective cohort study under the auspices of the Imperial College London. The international survey will interview members of three scientific societies (ISDE, AEC, AUGIS) with the primary aim of establishing the awareness of this technique among the members. The multicentric study will be conducted only with the members that have already performed cardioplasty for end stage achalasia.  

Aims: The primary aim of the cohort study is to assess the short and long term results of the patients that undergo cardioplasty for end-stage achalasia. The secondary aims of the study are to assess the variability of the surgical technique and how widespread is this operation.

Timeline of the study: The first questionnaire (Cardioplasty for end-stage achalasia: Part 1) will be distributed via email to the members of the chosen surgical societies from August 2020 to September 2020. Surgeons interested in taking part in the study must contact the researchers during this period in order to receive the second questionnaire (Cardioplasty for end-stage achalasia: Part 2). Data will be collected from September 2020 to November 2020 and further analysed to evaluate the practice of cardioplasty and the clinical results.

Email *

Current post *

Junior consultant

Senior consultant

Country where you work *

The hospital where you work is a *

Secondary level hospital (WHO: highly differentiated by function with 5 to 10 clinical specialties; size ranges from 200 to 800 beds; often referred to as a provincial hospital)

Tertiary level hospital (WHO: highly specialized staff and technical equipment; clinical services highly differentiated by function; could have teaching activities; size ranges from 300 to 1,500 beds)

Is there an Upper gastrointestinal surgical unit with surgeons specialized in benign upper GI surgery at your hospital? *

Yes

On average the number of patients with achalasia treated per year in your hospital *

State the surgical procedure most commonly performed for achalasia at your hospital

State the endoscopic procedure most commonly performed for achalasia at your hospital

How many patients with end-stage achalasia are referred to you or to your surgical department per year? (ISDE Guidelines 2018: end-stage achalasia is defined by barium swallow as a dilated esophagus, with retention of food and saliva, a sigmoid appearance of the esophageal body and a sump-shaped portion of the gastroesophageal junction) *

How do you usually treat patients with end stage achalasia? *

Oesophagectomy

Distal resection

Other:

Have you heard before about cardioplasty for the treatment of end-stage achalasia? *

Yes

Have you performed a cardioplasty for end-stage achalasia? *

Yes

If the previous answer was yes, how many procedures have you performed?

If you have performed a cardioplasty for end-stage achalasia, what suturing technique do you use for the oesophagogastric anastomosis?

Stapled

Manual

Clear selection

Would you be interested in participating in an international multicentric cohort study to evaluate the practice of cardioplasty for end-stage achalasia? *

Yes

Thank you for taking the time to complete this survey

If you are willing to participate in the study (question 14), please contact Fátima Senra via email (fatimasenra664@gmail.com) to further discuss the details and next steps.

A copy of your responses will be emailed to the address you provided.

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