The management of esophageal achalasia: from diagnosis to surgical treatment

Dobrowolsky, Adrian; Fisichella, P. Marco

doi:10.1007/s13304-013-0224-1

Cited by 9 publications

(9 citation statements)

References 73 publications

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“…Diagnostic testing often involves endoscopy to rule out mechanical obstruction, and fluoroscopic barium oesophagography. However, manometry is considered the gold-standard for diagnosis 10 11. Important diagnostic features are absent or incomplete lower oesophageal sphincter relaxation in response to swallowing on manometry, with aperistalsis in the oesophageal body, and characteristic appearances such as a ‘bird’s beak’ lower oesophageal tapering on barium oesophagography.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic treatment has focused on pneumatic dilation,17 although recently peroral oesophageal myotomy has been developed as an alternative endoscopic technique 18. Overall, a laparoscopic Heller myotomy with fundoplication offers the best short-term and long-term functional results in achalasia, although it is comparable to pneumatic dilatation in the short term 11 17…”

Section: Discussionmentioning

confidence: 99%

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Zenker’s diverticulum complicating achalasia: a ‘cup-and-spill’ oesophagus

et al. 2013

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SUMMARYA 72-year-old woman presented with long-standing gastro-oesophageal reflux, regurgitation of swallowed food and worsening cervical dysphagia. Fluoroscopic barium oesophagography revealed a posterolateral pharyngeal pouch (Zenker's diverticulum (ZD)) complicating a 'cup and spill' oesophageal deformity with a smoothly tapered segment at the gastrooesophageal junction. CT and high-resolution manometry confirmed that the underlying abnormality was a massively dilated oesophagus with aperistalsis and pan-oesophageal pressurisation, consistent with a diagnosis of oesophageal achalasia (type II). She underwent endoscopic stapled diverticulotomy, with good symptomatic relief. We discuss the aetiology of ZD, its management and the association here with oesophageal achalasia. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Zenker’s diverticulum complicating achalasia: a ‘cup-and-spill’ oesophagus

et al. 2013

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“…3) Pembedahan: pembedahan dilakukan dengan Heller myotomi, pada operasi ini otot esophagus pada daerah katup antara esophagus dan lambung diinsisi hingga mencapai submukosa oesophagus. 5 Komplikasi post operatif bisa terjadi obstruksi berkelanjutan, hal ini disebabkan oleh tidak efektifnya peristaltik pada akalasia esophagus yang panjang atau myotomi yang tidak komplit. Myotomi hingga dinding lambung dapat menyebabkan gastroesophagus reflux.…”

Section: Diskusiunclassified

Penatalaksanaan Akalasia Esophagus dengan Prosedur Pembedahan Heller Dilanjutkan Fundoplikasi

Rachmanio¹,

Alam²

2019

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Akalasia esophagus merupakan gangguan motilitas esophagus berupa hilangnya gerakan peristaltik dan kegagalan relaksasi dari lower esophageal sphincter. Kasus ini tergolong jarang yaitu sebanyak 0,5-1,6% dari seluruh populasi baik di Eropa, Asia, dan Amerika. Dilaporkan seorang anak laki-laki usia 14 bulan dengan keluhan sering muntah, berat badan kurang dan sulit naik. Pada pemeriksaan radiologis Oesophagus Maag Duodenum (OMD) ditemukan pelebaran oesophagus hingga gastrooesophageal junction. Dilakukan penatalaksanaan berupa pembedahan dengan prosedur Heller dilanjutkan dengan fundoplikasi. Pascaoperasi tidak ditemukan lagi keluhan pada pasien.

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“…The diagnosis is usually made with X-rays of the digestive tract with barium contrast medium (cm) administration and esophageal manometry [ 4 ]. The therapeutic approach may be pharmacological, endoscopic, and surgical [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Imaging in the Evaluation of Endoscopic or Surgical Treatment for Achalasia

Palladino

Mardighian

D'Amora

et al. 2016

Gastroenterology Research and Practice

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Purpose. Aim of the study is to evaluate the efficacy of the endoscopic (pneumatic dilation) versus surgical (Heller myotomy) treatment in patients affected by esophageal achalasia using barium X-ray examination of the digestive tract performed before and after the treatment. Materials and Methods. 19 patients (10 males and 9 females) were enrolled in this study; each patient underwent a barium X-ray examination to evaluate the esophageal diameter and the height of the barium column before and after endoscopic or surgical treatment. Results. The mean variation of oesophageal diameter before and after treatment is −2.1 mm for surgery and 1.74 mm for pneumatic dilation (OR 0.167, CI 95% 0.02–1.419, and P: 0.10). The variations of all variables, with the exception of the oesophageal diameter variation, are strongly related to the treatment performed. Conclusions. The barium X-ray study of the digestive tract, performed before and after different treatment approaches, demonstrates that the surgical treatment has to be considered as the treatment of choice of achalasia, reserving endoscopic treatment to patients with high operative risk and refusing surgery.

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The management of esophageal achalasia: from diagnosis to surgical treatment

Cited by 9 publications

References 73 publications

Zenker’s diverticulum complicating achalasia: a ‘cup-and-spill’ oesophagus

Zenker’s diverticulum complicating achalasia: a ‘cup-and-spill’ oesophagus

Penatalaksanaan Akalasia Esophagus dengan Prosedur Pembedahan Heller Dilanjutkan Fundoplikasi

Imaging in the Evaluation of Endoscopic or Surgical Treatment for Achalasia

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