Achalasia

Pandolfino, John E.; Gawron, Andrew J.

doi:10.1001/jama.2015.2996

Cited by 347 publications

(130 citation statements)

References 88 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…Its long-term retreatment rate (28.6%) was higher than after POEM (2.86%) (P=0.003). This conclusion was consistent with the previous literature [1]. The study suggested that repeated and "graded" dilation brought out good outcomes, but with the diameter increasing, a high perforation rate went up.…”

Section: Discussionsupporting

confidence: 92%

“…A c h a l a s i a a f f e c t s approximately 1 in 100,000 individuals [1], while co-existing esophageal varices with achalasia are quite rare. Ten cases have been reported in the English medical literature, seven of which received treatment [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Peroral endoscopic myotomy (POEM) is a minimally invasive endoscopic approach to the Heller myotomy for achalasia. Over the past 6 years, research has verified its safety and effectiveness to treat achalasia [1,6]. Additionally, the endoscopic approach allows the physician to visualize varices, which may permit better avoidance of bleeding complications and easier implementation of precise electrocautery.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

Shen

Wang

Zhang

et al. 2019

JGLD

View full text Add to dashboard Cite

Achalasia is very uncommon, and rarely does achalasia co-exist with esophageal varices. We present a 62-year-old woman who was diagnosed with both achalasia and esophageal varices in December 2014 and had a past history of hematemesis. The patient’s achalasia symptoms’ Eckardt score was 9, and her hepatic function was Child-Pugh grade A6. After comprehensive assessment of the patient’s health and discussion of the pros and cons of various therapies for achalasia, the patient underwent a peroral endoscopic myotomy. She was symptom-free after the operation and had no recurrence of achalasia symptoms at 20-month follow-up. No adverse events were reported. Peroral endoscopic myotomy for achalasia with esophageal varices has not been previously reported in the English literature.Abbreviations: BTI: Botulinum toxin injections; EUS: Endoscopic ultrasonography; GEJ: Gastroesophageal junction; HIFU: High-intensity focused ultrasound; LHM: Laparoscopic Heller myotomy; PD: Pneumatic dilation; POEM: Peroral endoscopic myotomy; TIPS: Transjugular intrahepatic portosystemic shunt.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

Shen

Wang

Zhang

et al. 2019

JGLD

View full text Add to dashboard Cite

show abstract

“…It has been reported that patients with achalasia have a variable prognosis after PD or LHM based on subtypes. Patients with type II achalasia have a very favorable outcome (96%); type I achalasia has intermediate prognosis (81%), while type III achalasia has less favorable outcomes (66%) [10,11]. In addition, it was reported that treatment success rate of PD (100%) was significantly higher than that of LHM (93%) for patients with type II achalasia, while the success rate of LHM (86%) tended to be significantly higher than that of PD (40%) in type III achalasia.…”

Section: Treatment Strategies For Achalasia Based On Subtypesmentioning

confidence: 99%

Diagnosis and Treatment Strategy of Achalasia Subtypes and Esophagogastric Junction Outflow Obstruction Based on High-Resolution Manometry

et al. 2017

View full text Add to dashboard Cite

Background: Based on Chicago Classification version 3.0, the disorders of esophagogastric junction outflow obstruction (EGJOO) include achalasia (types I, II and III) and EGJOO. Although no curative treatments are currently available for the treatment of the disorders of EGJOO, medical treatments, endoscopic pneumatic dilation (PD), laparoscopic Heller myotomy (LHM), and per-oral endoscopic myotomy (POEM) are usually the sought-after modes of treatment. Since the etiology and pathogenesis might vary depending on the types of EGJOO disorders, treatment strategies should be considered based on those subtypes. Summary: Based on the accumulated evidences, the treatment strategies of our institution are as follows: effects of medical treatments on achalasia are limited. Either PD or LHM/POEM can be considered a first-line in achalasia type I, according to the patient's wish. PD and POEM can be considered first-line in achalasia types II and III, respectively. Conversely, In EGJOO, medical treatments including drugs like acotiamide and/or diltiazem can be tested as a first-line, and PD and POEM will be considered second and third-line treatments, respectively. Key Messages: The classification of subtypes based on high-resolution manometry will help us consider which treatment option can be selected as a first-line treatment depending upon the subtypes of disorders of EGJOO. Acotiamide has the potential to cure patients with EGJOO.

show abstract

“…Both treatments will be discussed and compared, however for a more detailed review of the available literature, the reader is referred to some other excellent reviews [1,3,20]. …”

Section: Treatmentmentioning

confidence: 99%

Achalasia: From Bench to Peroral Endoscopic Myotomy

Boeckxstaens¹

2016

Dig Dis

View full text Add to dashboard Cite

Achalasia is a primary esophageal motility disorder with an estimated annual incidence of 1 per 100,000 persons. It is characterized by the absence of esophageal peristalsis and failure of the lower esophageal sphincter (LES) to relax upon swallowing, resulting in progressively severe dysphagia for solids and liquids, regurgitation, aspiration, chest pain and weight loss. Achalasia results from a loss of enteric neurons, most likely due to an autoimmune reaction in patients with a particular immunogenetic background. To date, 3 manometric subtypes have been identified based on high resolution manometry. To what extent these subtypes also indicate differences in underlying pathophysiological mechanisms is however unclear. As achalasia cannot be cured, treatment is confined to disruption of the LES to improve bolus passage and thereby relieving symptoms. The 2 most commonly used treatment modalities available for this purpose include pneumodilation and laparoscopic Heller myotomy. Both treatments have been shown repeatedly to be successful; however, success rates decline in time, most likely due to progression of the disease. A recent European randomized trial provides objective data indicating that both treatments are equally effective. In view of these data and the low incidence of the disease, the choice between these 2 treatments should be based on the expertise and experience available. Recently, excellent short-term success rates have been reported with a new endoscopic technique, that is, peroral endoscopic myotomy. However, longer follow-up data are absolutely needed before accepting this technique as a new treatment option for achalasia in clinical practice.

show abstract

Achalasia

Cited by 347 publications

References 88 publications

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

Diagnosis and Treatment Strategy of Achalasia Subtypes and Esophagogastric Junction Outflow Obstruction Based on High-Resolution Manometry

Achalasia: From Bench to Peroral Endoscopic Myotomy

Contact Info

Product

Resources

About