The Choice of Myotomy in Achalasia Cardia: Heller's or Per-Oral Endoscopic Myotomy
نویسندگان
چکیده
Achalasia cardia (AC) is a neurodegenerative disease which leads to loss of inhibitory myenteric neurons. This implies that, with the currently available treatment options, we offer palliation but not cure to these patients. Pneumatic balloon dilatation (PBD) has been the only time‐tested endoscopic modality for the management of AC until recently. However, the requirement of repeated dilatations remains a drawback. remains a drawback. But, the introduction of per oral endoscopic. The introduction of per oral endoscopic myotomy (POEM), along with growing evidence of its safety and efficacy, has strengthened the armamentarium for the management of AC.
منابع مشابه
Achalasia Cardia – Recent Advances in Diagnosis and Endoscopic Management
Achalasia Cardia is a rare neurodegenerative disorder of esophagus resulting in defective peristalsis and impaired relaxation of lower esophageal sphincter. The exact etiopathogenesis of achalasia is not known. Achalasia is associated with significant morbidity and impaired quality of life. The standard of care in patients with achalasia has been pneumatic balloon dilatation and laparoscopic he...
متن کاملPer-oral endoscopic myotomy (POEM): a new endoscopic treatment for achalasia.
BACKGROUND/AIMS Per-oral endoscopic myotomy (POEM) is a new minimally invasive technique to treat achalasia. METHODS We performed a review of the literature of POEM with a special focus on technical details and the results obtained with this technique in patients with achalasia and other esophageal motility disorders. RESULTS Thousands of POEM procedures have been performed worldwide since ...
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BACKGROUND Esophageal achalasia is the most common primary esophageal motor disorder. Laparoscopic Heller's myotomy combined with fundoplication represents the treatment of choice for this disease, achieving good results in about 90% of patients. However, about 10% of treated patients refer persistent or recurrent dysphagia. Many Authors showed that this failure rate is related to inadequate my...
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Background/Aims Achalasia cardia (AC) is a motility disorder, characterized by impaired lower esophageal sphincter relaxation and absence of esophageal peristalsis. AC is rare in children with unclear optimum management strategies. Per oral endoscopic myotomy (POEM) is a novel technique for management of achalasia with encouraging results in adult patients. The efficacy and safety of POEM is no...
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OBJECTIVE To compare symptomatic and objective outcomes between HM and POEM. BACKGROUND The surgical gold standard for achalasia is laparoscopic Heller myotomy (HM) and partial fundoplication. Per-oral endoscopic myotomy (POEM) is a less invasive flexible endoscopic alternative. We compare their safety and efficacy. METHODS Data on consecutive HMs and POEMs for achalasia from 2007 to 2012 w...
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