Traitement endoscopique de l’achalasie : dilatation pneumatique, chirurgie ou myotomie pérorale endoscopique ?

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• 作者：V. Lépilliez (1325)
  
• 关键词：Achalasie ; Dilatation pneumatique oesophagienne ; Injection de toxine botulique ; Myotomie de Heller ; Dor ; Myotomie endoscopique ?sophagienne ; Achalasia ; Pneumatic dilatation ; Botulinum toxin injection ; Heller ; Dor myotomy ; Peroral endoscopic myotomy
• 刊名：Acta Endoscopica
• 出版年：2013
• 出版时间：March 2013
• 年：2013
• 卷：43
• 期：3
• 页码：82-88
• 全文大小：271KB
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• 作者单位：V. Lépilliez (1325)
  
  1325. H?pital privé Jean Mermoz, 55 avenue Jean Mermoz, F-69008, Lyon, France
  

文摘

Achalasia is an esophageal motility disorder defined by the absence of propagated contractions (aperistalsis) in the body of the esophagus and failure of relaxation of the lower esophageal sphincter. Thanks to high resolution manometry and study of the esophageal pressure topography, three subtypes, according to the classification of Chicago, have a direct interest in the choice of treatment to use: type I of achalasia presents the same result with pneumatic dilatation (81%) and surgery (85%); type II of achalasia presents the best result with pneumatic dilatation (100%); type III of achalasia called “spastic- which is the more resistant, have the best result with Heller-Dor myotomy (86%). More recently appeared the peroral endoscopic myotomy, which remains to study in France, but with the preliminary results, this technic could become the treatment of choice for achalasia, particularly in the type III which is the most resistant.