タイトル(別表記) An effective case of peroral endoscopic myotomy for esophageal abnormal peristalsis after Heller-Dor myotomy
著者 杉原 雄策| 原田 馨太| 加藤 諒| 山内 健司| 髙嶋 志保| 山崎 泰史| 井口 俊博| 高原 政宏| 川野 誠司| 平岡 佐規子| 眞部 紀明| 大塚 文男| 岡田 裕之|
抄録 Esophageal achalasia is a disorder of the lower esophageal sphincter muscle. Our patient, a Japanese male in his 80's, had been experiencing dysphagia for almost 60 years. He was treated with balloon dilations and Heller-Dor 5 years prior to his present admission. Esophagogastroduodenoscopy, esophageal radiography, and high-myotomy manometry indicated that the symptoms were likely due to abnormal peristalsis. With the patient’s informed consent, we performed a peroral endoscopic myotomy(POEM). The patient was discharged 4 days post-surgery. At the 6-month postoperative examination, no worsening of symptoms or relapse was observed. POEM is an excellent treatment method for esophageal achalasia from the perspective of therapeutic effect. We recommend that POEM be considered as the first-choice treatment for abnormal peristalsis after a Heller-Dor myotomy.
キーワード POEM(peroral endoscopic myotomy) 食道アカラシア(esophageal achalasia)
出版物タイトル 岡山医学会雑誌
発行日 2018-08-01
130巻
2号
開始ページ 67
終了ページ 71
ISSN 0030-1558
関連URL isVersionOf https://doi.org/10.4044/joma.130.67
言語 Japanese
著作権者 Copyright (c) 2018 岡山医学会
論文のバージョン publisher
DOI 10.4044/joma.130.67
NAID 130007481050
タイトル(別表記) Achalasia treated with per-oral endoscopic myotomy (POEM)
著者 杉原 雄策| 原田 馨太| 加藤 諒| 山内 健司| 高嶋 志保| 竹井 大介| 井口 俊博| 高原 政宏| 川野 誠司| 平岡 佐規子| 田辺 俊介| 野間 和宏| 白川 靖博| 眞部 紀明| 井上 晴洋| 岡田 裕之|
抄録 Esophageal achalasia is a disorder of the lower esophageal sphincter muscle. Patients present with dysphagia, chest pain, vomiting, and aspiration. Esophageal achalasia had traditionally been treated with esophageal achalasia balloon dilatation and the Heller-Dor method, but in recent years, the use of per-oral endoscopic myotomy (POEM) has increased. Our patient, a 39-yr-old male, began experiencing dysphagia 4 years prior to his referral to our hospital. Based on the results of esophagogastroduodenoscopy, esophageal radiography and high-resolution manometry, we made the diagnosis of esophageal achalasia (Chicago classification type I) . After informed consent from the patient and his family and approval from our hospital's ethics committee were obtained, we performed a POEM. The patient was discharged on the 4th day post-surgery. At the 1-year post-operative examination, no worsening of symptoms and no relapse were observed. POEM is an excellent treatment method for esophageal achalasia from the perspective of therapeutic effect and prevention of invasion. We recommend that it be considered as the first-choice treatment for achalasia. However, accessibility to the procedure itself is limited due to the few adequately trained operators worldwide. POEM should thus be performed by an expert operator at a high-volume center.
キーワード POEM 食道アカラシア (esophageal achalasia)
出版物タイトル 岡山医学会雑誌
発行日 2017-08-01
129巻
2号
開始ページ 115
終了ページ 121
ISSN 0030-1558
関連URL https://doi.org/10.4044/joma.129.115
言語 Japanese
著作権者 Copyright (c) 2017 岡山医学会
論文のバージョン publisher
DOI 10.4044/joma.129.115