TABLE 1.
Presurgical characteristics of the study population according to chest pain.
| Total | W/o chest pain | With chest pain | P-value | P-value | P-value | |
| (n = 129) | (n = 21) | (n = 108) | Total vs. w/o CP | Total vs. w/CP | w/o vs. w/CP | |
| Demographics | ||||||
| Age (years), mean ± SD | 40.6 ± 14.2 | 39.7 ± 13.7 | 40.8 ± 14.3 | 0.973 | ||
| median | 39.0 | 38.0 | 39.5 | |||
| range | 18–78 | 18–68 | 18–78 | |||
| Sex: female; n, (%)/male; n, (%) | 74 (57)/55 (43) | 10 (48)/11 (52) | 64 (59)/44 (41) | NS | NS | NS |
| Ratio F/M | 1.35 | 0.91 | 1.45 | |||
| Clinical variables | ||||||
| BMI (Kg/m2), mean ± SD | 23.2 ± 4.8 | 24.1 ± 5.7 | 23.0 ± 4.6 | 0.730 | ||
| median | 22.5 | 23.1 | 22.4 | |||
| range | 14.6–41.2 | 14.6–36.8 | 15.6–41.2 | |||
| Overweight; n, (%) | 27 (21) | 5 (24) | 22 (20) | NS | NS | NS |
| Obesity; n, (%) | 12 (9) | 4 (19) | 8 (7) | NS | NS | NS |
| Autoimmune disease; n, (%) | 14 (11) | 1 (5) | 13 (12) | NS | NS | NS |
| Inflammatory diseases; n, (%) | 22 (17) | 1 (5) | 21 (19) | NS | NS | NS |
| Type of achalasia | ||||||
| I; n, (%) | 48 (37) | 7 (33) | 41 (38) | NS | NS | NS |
| II; n, (%) | 79 (61) | 13 (62) | 66 (61) | |||
| III; n, (%) | 2 (2) | 1 (5) | 1 (1) | |||
| Disease evolution (Months), mean ± SD | 25.5 ± 26.2 | 20.1 ± 25.9 | 26.5 ± 26.3 | 0.239 | ||
| median | 14.5 | 10.0 | 16.0 | |||
| range | 1–144 | 1–108 | 1–144 | |||
| Symptoms | ||||||
| Chest pain; n, (%) | 108 (84) | 0 (0) | 108 (100) | <0.00001 | NS | <0.00001 |
| Dysphagia; n, (%) | 129 (100) | 21 (100) | 108 (100) | NS | NS | NS |
| Liquids; n, (%) | 10 (8) | 2 (10) | 8 (7) | NS | NS | NS |
| Solids; n, (%) | 38 (29) | 8 (38) | 30 (28) | NS | NS | NS |
| Both; n, (%) | 81 (63) | 11 (52) | 70 (65) | NS | NS | NS |
| Regurgitation; n, (%) | 120 (93) | 19 (90) | 100 (93) | NS | NS | NS |
| Weight loss, n, (%) | 120 (93) | 21 (100) | 98 (91) | NS | NS | NS |
| Questionnaires | ||||||
| Eckart (score), mean ± SD | 9.0 ± 2.7 | 8.0 ± 4.5 | 9.2 ± 2.2 | <0.050 | NS | <0.050 |
| median | 9.0 | 8.0 | 9.0 | |||
| range | 3–26 | 3–26 | 4–13 | |||
| GERD-HRQL (score), mean ± SD | 24.1 ± 12.5 | 13.8 ± 6.6 | 26.1 ± 12.3 | <0.050 | NS | <0.050 |
| median | 22.0 | 12.0 | 23.5 | |||
| range | 4–49 | 4–27 | 5–49 | |||
| EAT-10 (score), mean ± SD | 29.4 ± 9.1 | 21.2 ± 8.3 | 31.1 ± 8.3 | <0.050 | NS | <0.050 |
| median | 32.0 | 22.0 | 34.0 | |||
| range | 4–43 | 4–35 | 4–43 | |||
| Viral exanthemata’s childhood disease | ||||||
| Chickenpox; n, (%) | 91 (71) | 14 (67) | 77 (71) | NS | NS | NS |
| Measles; n, (%) | 41 (32) | 4 (19) | 37 (34) | NS | NS | NS |
| Rubella; n, (%) | 11 (9) | 0 (0) | 11 (10) | NS | NS | NS |
| Hepatitis; n, (%) | 3 (2) | 1 (5) | 2 (2) | NS | NS | NS |
| Mumps; n, (%) | 11 (9) | 3 (14) | 8 (7) | NS | NS | NS |
| Environmental exposure | ||||||
| Tobacco exposure; n, (%) | 40 (31) | 9 (43) | 31 (29) | NS | NS | NS |
| Biomass exposure; n, (%) | 32 (25) | 4 (19) | 28 (26) | NS | NS | NS |
| Laboratory data | ||||||
| Anti-nuclear antibodies; (%) | 39/108 (36) | 9/19 (47) | 30/89 (34) | |||
| Neutrophil to lymphocyte ratio mean ± SD | 2.2 ± 1.2 | 2.1 ± 0.9 | 2.2 ± 1.3 | 0.980 | ||
| median | 1.9 | 1.9 | 1.9 | |||
| range | 0.6–7.7 | 1.1–4.8 | 0.6–7.7 | |||
| Previous treatments | ||||||
| Pneumatic dilation; n, (%) | 70 (54) | 12 (57) | 58 (54) | NS | NS | NS |
| Pneumatic dilation sessions, mean ± SD | 1.3 ± 0.6 | 1.0 ± 0.1 | 1.4 ± 0.7 | NS | NS | NS |
| median | 1.0 | 1.0 | 1.0 | |||
| range | 1–3 | 1–1 | 1–3 | |||
| Preoperative diagnostic studies | ||||||
| Barium swallow | ||||||
| Esophageal dilatation (cm), mean ± SD | 4.9 ± 1.7 | 4.1 ± 1.8 | 5.1 ± 1.6 | 0.066 | ||
| median | 4.7 | 4.1 | 5.0 | |||
| range | 0.0–10.5 | 0.0–8.2 | 0.0–10.5 | |||
| Esophageal shape, n (%) | ||||||
| Flask | 89 (69) | 12 (57) | 77 (71.3) | NS | NS | NS |
| Spindle | 28 (22) | 7 (33) | 21 (19.3) | NS | NS | NS |
| Sigmoid | 12 (9) | 2 (10) | 10 (9.3) | NS | NS | NS |
| Degree esophageal dilatation | ||||||
| First degree†; n, (%) | 23 (18) | 6 (29) | 17 (15) | NS | NS | NS |
| Second degree†; n, (%) | 65 (50) | 11 (52) | 59 (55) | NS | NS | NS |
| Third degree†; n, (%) | 33 (26) | 2 (10) | 32 (30) | NS | NS | NS |
| High-resolution manometry | ||||||
| Basal LES pressure (mmHg), mean ± SD | 41.1 ± 24.5 | 37.2 ± 18.1 | 41.9 ± 25.5 | 0.857 | ||
| median | 38.7 | 35.8 | 38.8 | |||
| range | 11.7–162.0 | 13.0–80.0 | 11.7–162.0 | |||
| IRP (mmHg), mean ± SD | 29.4 ± 13.8 | 28.3 ± 15.2 | 29.6 ± 13.5 | 0.740 | ||
| median | 28.0 | 24.1 | 28.3 | |||
| range | 5.1–82.2 | 11.2–81.0 | 5.1–82.2 | |||
| IRP > 15 mmHg; n, (%) | 121 (94) | 19 (90) | 102 (94) | NS | NS | NS |
| Amplitude distal contractions, | ||||||
| mean ± SD | 15.4 ± 23.2 | 22.2 ± 26.7 | 14.0 ± 22.3 | 0.396 | ||
| median | 0.0 | 0.0 | 0.0 | |||
| range | 0.0–104.8 | 0.0–71.0 | 0.0–104.8 | |||
| Distal contractile integral (mmHg/s/cm), mean ± SD | 1072.9 ± 4340.0 | 538.8 ± 1193.9 | 1184.4 ± 4738.6 | 0.893 | ||
| median | 0.0 | 0.0 | 0.0 | |||
| range | 0.0–37970 | 0.0–4611.0 | 0.0–37970 | |||
| Ineffective (Fail or weak); n, (%) | 82 (73) | 17 (81) | 65 (60) | NS | NS | NS |
| Failed peristalsis (DCI < 100); n, (%) | 77 (68) | 15 (71) | 62 (57) | NS | NS | NS |
| Weak peristalsis (DCI > 100 but < 450); n, (%) | 5 (4) | 2 (10) | 3 (3) | NS | NS | NS |
| Normal (DCI > 450 but < 8,000); n, (%) | 20 (18) | 4 (19) | 16 (15) | NS | NS | NS |
| Hypercontractile (> 8,000); n, (%) | 4 (3) | 0 (0) | 4 (4) | 1 | 1 | 1 |
| Vigorous achalasia (Amplitude distal contractions > 37); n, (%) | 21 (19) | 7 (33) | 14 (13) | 0.0743 | 0.582 | 0.0458 |
Numbers may not sum to totals due to missing data, and column percentages may not sum to 100% due to rounding. BMI, body mass index; cm, centimeter; DCI, distal contractile integral; HRM, High-resolution manometry; IRP, Integrated relaxation pressure; Kg, kilogram; LES, Lower esophageal sphincter; min, minute; mmHg, millimeters of mercury; NS, Not significant; ps, pre-surgery; s, second; SD, standard deviation; w/o, without, w/o CP, without chest pain; w/CP, with chest pain. † First degree of dilatation (< 3.5 cm), second degree (≥ 3.5 < 6 cm), third-degree (≥ 6). In bold statistically significant (p < 0.05) variables.