Recent Trends in the Management of Achalasia

被引:20
作者
Katada, Natsuya [1 ]
Sakuramoto, Shinichi [1 ]
Yamashita, Keishi [1 ]
Shibata, Tomotaka [1 ]
Moriya, Hiromitsu [1 ]
Kikuchi, Shiro [1 ]
Watanabe, Masahiko [1 ]
机构
[1] Kitasato Univ, Sch Med, Dept Surg, Minami Ku, Sagamihara, Kanagawa 2520380, Japan
关键词
achalasia; pneumatic dilation; laparoscopic Heller myotomy; per oral endoscopic myotomy; LAPAROSCOPIC HELLER MYOTOMY; THORACOSCOPY-ASSISTED TREATMENT; ESOPHAGEAL MOTILITY DISORDERS; MINIMALLY INVASIVE TECHNIQUE; RANDOMIZED CONTROLLED-TRIAL; PERORAL ENDOSCOPIC MYOTOMY; SPHINCTER PRESSURE; DOR FUNDOPLICATION; PNEUMATIC DILATION; TOUPET FUNDOPLICATION;
D O I
10.5761/atcs.ra.12.01949
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Radical treatment for achalasia is currently unavailable. At present, most palliative procedures are designed improve the passage of food through the gastroesophageal junction and thereby alleviate symptoms. Drug therapy is of limited, transient effectiveness. Pneumatic dilation (PD) is considered superior to endoscopic botulinum toxin injection (EBTI). The mainstay of surgical treatment for achalasia is laparoscopic Heller myotomy (LHM) with fundoplication, currently considered superior to PD. Per oral endoscopic myotomy (POEM), a "state-of-the-art" procedure for minimally invasive surgery, holds great promise for the future management of achalasia. Definitive conclusions regarding the benefits and risks of currently available treatments for achalasia must await the accumulation of evidence from well-designed clinical trials.
引用
收藏
页码:420 / 428
页数:9
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