Objective: To review the current management of achalasia, and the controversies regarding the different treatment options.
Methods: A review of the literature was performed. The key words used were esophageal achalasia, Heller myotomy, endoscopic balloon dilatation, laparoscopic Heller myotomy, and fundoplication.
Results: Patients who fail medical therapy (e.g. pharmacologic therapy, botulinum toxin, balloon dilatation) should be considered for surgical therapy for the management of achalasia. Currently, numerous surgical procedures exist for the treatment of achalasia (transabdominal cardiomyotomy, thoracoscopic or open transthoracic cardiomyotomy, and laparoscopic Heller myotomy with an antireflux procedure).
Conclusions: Laparoscopic Heller myotomy is generally accepted as the operative procedure of choice for achalasia. However, controversy exists as to whether a concomitant antireflux procedure is necessary, and if so, what type should be performed. Given the deleterious effects of postoperative reflux, and the facility of including an antireflux procedure at the time of the myotomy, there is merit in undertaking an antireflux procedure at the time of the laparoscopic Heller myotomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1159/000079341 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Infantile achalasia cardia: A rare case report of a 3-month-old female with recurrent pneumonia successfully treated with surgical intervention.
Int J Surg Case Rep
December 2024
Department of Pediatric Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Introduction: Achalasia, a rare esophageal disorder with an annual incidence of 0.11 per 100,000 in children, is characterized by impaired lower esophageal sphincter (LES) relaxation and peristalsis. Infantile cases are extremely uncommon and often linked to genetic conditions like Allgrove and Down syndrome.
View Article and Find Full Text PDFComparison of peroral endoscopic myotomy, laparoscopic Heller myotomy, and pneumatic dilation for patients with achalasia: a United States national experience.
Clin Endosc
December 2024
Division of Gastroenterology, Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, KS, USA.
Background: Achalasia is a motility disorder of the esophagus and depending on its type, esophageal tubular hypo- or hypermotility can cause typical symptoms, such as dysphagia, chest pain, weight loss, or regurgitation. Clinical symptoms during initial diagnosis as well as over the course of therapy can be measured by the Eckardt score. Diagnostics include high-resolution manometry (HR manometry), (timed barium) esophagogram, upper gastrointestinal endoscopy, multiple rapid swallow response, and Endo-FLIP measurement.
View Article and Find Full Text PDFThe impact of robotic surgery on the treatment of benign esophageal and gastric disease: early experience of a specialized unit.
J Robot Surg
December 2024
1st Propaedeutic Surgery Clinic, Hippocration General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Laparoscopic surgery is a well-established approach in the surgical treatment of reflux, hiatal hernia and esophageal motility disorders such as achalasia. Robotic platforms have only recently been incorporated in surgery for esophageal motility disorders and their exact value remains to be determined. In the present study, we present the preliminary results of our early experience with a case series of benign upper gastrointestinal diseases treated using the robotic system in our department.
View Article and Find Full Text PDF[Endoscopic Treatment for Esophageal Achalasia:Per-oral Endoscopic Myotomy( POEM)].
Kyobu Geka
September 2024
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.
Per-oral endoscopic myotomy( POEM) is an endoscopic treatment of achalasia. Since the world's first case was performed in Japan in 2008, over 15 years have passed. More than 3,200 cases have been performed at Showa University alone, and over 6,000 cases have been performed throughout Japan.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!