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Erschienen in: Updates in Surgery 1/2014

01.03.2014 | Review Article

The management of esophageal achalasia: from diagnosis to surgical treatment

verfasst von: Adrian Dobrowolsky, P. Marco Fisichella

Erschienen in: Updates in Surgery | Ausgabe 1/2014

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Abstract

The goal of this review is to illustrate our approach to patients with achalasia in terms of preoperative evaluation and surgical technique. Indications, patient selection and management are herein discussed. Specifically, we illustrate the pathogenetic theories and diagnostic algorithm with current up-to-date techniques to diagnose achalasia and its manometric variants. Finally, we focus on the therapeutic approaches available today: medical and surgical. A special emphasis is given on the surgical treatment of achalasia and we provide the reader with a detailed description of our pre and postoperative management.
Literatur
1.
Zurück zum Zitat Willis T (1674) Pharmaceutice rationalis sive diatribe de medicamentorum operationibus in humano corpore. Hagae-Comitis, London Willis T (1674) Pharmaceutice rationalis sive diatribe de medicamentorum operationibus in humano corpore. Hagae-Comitis, London
2.
Zurück zum Zitat Hurst AF, Rowlands RP (1924) Case of achalasia of the cardia relieved by operation. Proc R Soc Med 17(Clin Sect):45–46 Hurst AF, Rowlands RP (1924) Case of achalasia of the cardia relieved by operation. Proc R Soc Med 17(Clin Sect):45–46
3.
Zurück zum Zitat Crist J, Gidda JS, Goyal RK (1984) Intramural mechanism of esophageal peristalsis: roles of cholinergic and noncholinergic nerves. Proc Natl Acad Sci USA 81(11):3595–3599PubMedCrossRef Crist J, Gidda JS, Goyal RK (1984) Intramural mechanism of esophageal peristalsis: roles of cholinergic and noncholinergic nerves. Proc Natl Acad Sci USA 81(11):3595–3599PubMedCrossRef
4.
Zurück zum Zitat Mearin F, Mourelle M, Guarner F et al (1993) Patients with achalasia lack nitric oxide synthase in the gastro-oesophageal junction. Eur J Clin Invest 23(11):724–728PubMedCrossRef Mearin F, Mourelle M, Guarner F et al (1993) Patients with achalasia lack nitric oxide synthase in the gastro-oesophageal junction. Eur J Clin Invest 23(11):724–728PubMedCrossRef
5.
Zurück zum Zitat Murray J, Du C, Ledlow A, Bates JN, Conklin JL (1991) Nitric oxide: mediator of nonadrenergic noncholinergic responses of opossum esophageal muscle. Am J Physiol 261(3 Pt 1):G401–G406PubMed Murray J, Du C, Ledlow A, Bates JN, Conklin JL (1991) Nitric oxide: mediator of nonadrenergic noncholinergic responses of opossum esophageal muscle. Am J Physiol 261(3 Pt 1):G401–G406PubMed
6.
Zurück zum Zitat Yamato S, Spechler SJ, Goyal RK (1992) Role of nitric oxide in esophageal peristalsis in the opossum. Gastroenterology 103(1):197–204PubMed Yamato S, Spechler SJ, Goyal RK (1992) Role of nitric oxide in esophageal peristalsis in the opossum. Gastroenterology 103(1):197–204PubMed
7.
Zurück zum Zitat De Giorgio R, Di Simone MP, Stanghellini V et al (1999) Esophageal and gastric nitric oxide synthesizing innervation in primary achalasia. Am J Gastroenterol 94(9):2357–2362PubMedCrossRef De Giorgio R, Di Simone MP, Stanghellini V et al (1999) Esophageal and gastric nitric oxide synthesizing innervation in primary achalasia. Am J Gastroenterol 94(9):2357–2362PubMedCrossRef
8.
Zurück zum Zitat Khelif K, De Laet MH, Chaouachi B, Segers V, Vanderwinden JM (2003) Achalasia of the cardia in Allgrove’s (triple A) syndrome: histopathologic study of 10 cases. Am J Surg Pathol 27(5):667–672PubMedCrossRef Khelif K, De Laet MH, Chaouachi B, Segers V, Vanderwinden JM (2003) Achalasia of the cardia in Allgrove’s (triple A) syndrome: histopathologic study of 10 cases. Am J Surg Pathol 27(5):667–672PubMedCrossRef
9.
Zurück zum Zitat Goyal RK, Rattan S, Said SI (1980) VIP as a possible neurotransmitter of non-cholinergic non-adrenergic inhibitory neurones. Nature 288(5789):378–380PubMedCrossRef Goyal RK, Rattan S, Said SI (1980) VIP as a possible neurotransmitter of non-cholinergic non-adrenergic inhibitory neurones. Nature 288(5789):378–380PubMedCrossRef
10.
Zurück zum Zitat Rattan S, Grady M, Goyal RK (1982) Vasoactive intestinal peptide causes peristaltic contractions in the esophageal body. Life Sci 30(18):1557–1563PubMedCrossRef Rattan S, Grady M, Goyal RK (1982) Vasoactive intestinal peptide causes peristaltic contractions in the esophageal body. Life Sci 30(18):1557–1563PubMedCrossRef
11.
Zurück zum Zitat Ghoshal UC, Daschakraborty SB, Singh R (2012) Pathogenesis of achalasia cardia. World J Gastroenterol 18(24):3050–3057PubMedCrossRef Ghoshal UC, Daschakraborty SB, Singh R (2012) Pathogenesis of achalasia cardia. World J Gastroenterol 18(24):3050–3057PubMedCrossRef
12.
Zurück zum Zitat de Oliveira RB, Rezende Filho J, Dantas RO, Iazigi N (1995) The spectrum of esophageal motor disorders in Chagas’ disease. Am J Gastroenterol 90(7):1119–1124PubMed de Oliveira RB, Rezende Filho J, Dantas RO, Iazigi N (1995) The spectrum of esophageal motor disorders in Chagas’ disease. Am J Gastroenterol 90(7):1119–1124PubMed
13.
Zurück zum Zitat Goldblum JR, Rice TW, Richter JE (1996) Histopathologic features in esophagomyotomy specimens from patients with achalasia. Gastroenterology 111(3):648–654PubMedCrossRef Goldblum JR, Rice TW, Richter JE (1996) Histopathologic features in esophagomyotomy specimens from patients with achalasia. Gastroenterology 111(3):648–654PubMedCrossRef
14.
Zurück zum Zitat Raymond L, Lach B, Shamji FM (1999) Inflammatory aetiology of primary oesophageal achalasia: an immunohistochemical and ultrastructural study of auerbach’s plexus. Histopathology 35(5):445–453PubMedCrossRef Raymond L, Lach B, Shamji FM (1999) Inflammatory aetiology of primary oesophageal achalasia: an immunohistochemical and ultrastructural study of auerbach’s plexus. Histopathology 35(5):445–453PubMedCrossRef
15.
Zurück zum Zitat Storch WB, Eckardt VF, Wienbeck M et al (1995) Autoantibodies to auerbach’s plexus in achalasia. Cell Mol Biol (Noisy-le-grand) 41(8):1033–1038 Storch WB, Eckardt VF, Wienbeck M et al (1995) Autoantibodies to auerbach’s plexus in achalasia. Cell Mol Biol (Noisy-le-grand) 41(8):1033–1038
16.
Zurück zum Zitat Verne GN, Sallustio JE, Eaker EY (1997) Anti-myenteric neuronal antibodies in patients with achalasia. A prospective study. Dig Dis Sci 42(2):307–313PubMedCrossRef Verne GN, Sallustio JE, Eaker EY (1997) Anti-myenteric neuronal antibodies in patients with achalasia. A prospective study. Dig Dis Sci 42(2):307–313PubMedCrossRef
17.
Zurück zum Zitat Ruiz-de-Leon A, Mendoza J, Sevilla-Mantilla C et al (2002) Myenteric antiplexus antibodies and class II HLA in achalasia. Dig Dis Sci 47(1):15–19PubMedCrossRef Ruiz-de-Leon A, Mendoza J, Sevilla-Mantilla C et al (2002) Myenteric antiplexus antibodies and class II HLA in achalasia. Dig Dis Sci 47(1):15–19PubMedCrossRef
18.
Zurück zum Zitat Wong RK, Maydonovitch CL, Metz SJ, Baker JR Jr (1989) Significant DQw1 association in achalasia. Dig Dis Sci 34(3):349–352PubMedCrossRef Wong RK, Maydonovitch CL, Metz SJ, Baker JR Jr (1989) Significant DQw1 association in achalasia. Dig Dis Sci 34(3):349–352PubMedCrossRef
19.
Zurück zum Zitat Latiano A, De Giorgio R, Volta U et al (2006) HLA and enteric antineuronal antibodies in patients with achalasia. Neurogastroenterol Motil 18(7):520–525PubMedCrossRef Latiano A, De Giorgio R, Volta U et al (2006) HLA and enteric antineuronal antibodies in patients with achalasia. Neurogastroenterol Motil 18(7):520–525PubMedCrossRef
20.
Zurück zum Zitat Mayberry JF, Atkinson M (1985) A study of swallowing difficulties in first degree relatives of patients with achalasia. Thorax 40(5):391–393PubMedCrossRef Mayberry JF, Atkinson M (1985) A study of swallowing difficulties in first degree relatives of patients with achalasia. Thorax 40(5):391–393PubMedCrossRef
21.
Zurück zum Zitat Tullio-Pelet A, Salomon R, Hadj-Rabia S et al (2000) Mutant WD-repeat protein in triple-A syndrome. Nat Genet 26(3):332–335PubMedCrossRef Tullio-Pelet A, Salomon R, Hadj-Rabia S et al (2000) Mutant WD-repeat protein in triple-A syndrome. Nat Genet 26(3):332–335PubMedCrossRef
22.
Zurück zum Zitat Mayberry JF, Atkinson M (1985) Studies of incidence and prevalence of achalasia in the Nottingham area. Q J Med 56(220):451–456PubMed Mayberry JF, Atkinson M (1985) Studies of incidence and prevalence of achalasia in the Nottingham area. Q J Med 56(220):451–456PubMed
23.
Zurück zum Zitat Ho KY, Tay HH, Kang JY (1999) A prospective study of the clinical features, manometric findings, incidence and prevalence of achalasia in Singapore. J Gastroenterol Hepatol 14(8):791–795PubMedCrossRef Ho KY, Tay HH, Kang JY (1999) A prospective study of the clinical features, manometric findings, incidence and prevalence of achalasia in Singapore. J Gastroenterol Hepatol 14(8):791–795PubMedCrossRef
24.
Zurück zum Zitat Sadowski DC, Ackah F, Jiang B, Svenson LW (2010) Achalasia: incidence, prevalence and survival. A population-based study. Neurogastroenterol Motil 22(9):e256–e261PubMedCrossRef Sadowski DC, Ackah F, Jiang B, Svenson LW (2010) Achalasia: incidence, prevalence and survival. A population-based study. Neurogastroenterol Motil 22(9):e256–e261PubMedCrossRef
25.
Zurück zum Zitat Fisichella PM, Raz D, Palazzo F, Niponmick I, Patti MG (2008) Clinical, radiological, and manometric profile in 145 patients with untreated achalasia. World J Surg 32(9):1974–1979PubMedCrossRef Fisichella PM, Raz D, Palazzo F, Niponmick I, Patti MG (2008) Clinical, radiological, and manometric profile in 145 patients with untreated achalasia. World J Surg 32(9):1974–1979PubMedCrossRef
26.
Zurück zum Zitat Crookes PF, Corkill S, DeMeester TR (1997) Gastroesophageal reflux in achalasia. When is reflux really reflux? Dig Dis Sci 42(7):1354–1361PubMedCrossRef Crookes PF, Corkill S, DeMeester TR (1997) Gastroesophageal reflux in achalasia. When is reflux really reflux? Dig Dis Sci 42(7):1354–1361PubMedCrossRef
27.
Zurück zum Zitat Patti MG, Arcerito M, Tong J et al (1997) Importance of preoperative and postoperative pH monitoring in patients with esophageal achalasia. J Gastrointest Surg 1(6):505–510PubMedCrossRef Patti MG, Arcerito M, Tong J et al (1997) Importance of preoperative and postoperative pH monitoring in patients with esophageal achalasia. J Gastrointest Surg 1(6):505–510PubMedCrossRef
28.
Zurück zum Zitat Spechler SJ, Souza RF, Rosenberg SJ, Ruben RA, Goyal RK (1995) Heartburn in patients with achalasia. Gut 37(3):305–308PubMedCrossRef Spechler SJ, Souza RF, Rosenberg SJ, Ruben RA, Goyal RK (1995) Heartburn in patients with achalasia. Gut 37(3):305–308PubMedCrossRef
29.
Zurück zum Zitat Spiess AE, Kahrilas PJ (1998) Treating achalasia: from whalebone to laparoscope. JAMA 280(7):638–642PubMedCrossRef Spiess AE, Kahrilas PJ (1998) Treating achalasia: from whalebone to laparoscope. JAMA 280(7):638–642PubMedCrossRef
30.
Zurück zum Zitat Leeuwenburgh I, Scholten P, Alderliesten J et al (2010) Long-term esophageal cancer risk in patients with primary achalasia: a prospective study. Am J Gastroenterol 105(10):2144–2149PubMedCrossRef Leeuwenburgh I, Scholten P, Alderliesten J et al (2010) Long-term esophageal cancer risk in patients with primary achalasia: a prospective study. Am J Gastroenterol 105(10):2144–2149PubMedCrossRef
31.
Zurück zum Zitat Sandler RS, Nyren O, Ekbom A, Eisen GM, Yuen J, Josefsson S (1995) The risk of esophageal cancer in patients with achalasia. A population-based study. JAMA 274(17):1359–1362PubMedCrossRef Sandler RS, Nyren O, Ekbom A, Eisen GM, Yuen J, Josefsson S (1995) The risk of esophageal cancer in patients with achalasia. A population-based study. JAMA 274(17):1359–1362PubMedCrossRef
32.
Zurück zum Zitat Lehman MB, Clark SB, Ormsby AH, Rice TW, Richter JE, Goldblum JR (2001) Squamous mucosal alterations in esophagectomy specimens from patients with end-stage achalasia. Am J Surg Pathol 25(11):1413–1418PubMedCrossRef Lehman MB, Clark SB, Ormsby AH, Rice TW, Richter JE, Goldblum JR (2001) Squamous mucosal alterations in esophagectomy specimens from patients with end-stage achalasia. Am J Surg Pathol 25(11):1413–1418PubMedCrossRef
33.
Zurück zum Zitat Zaninotto G, Rizzetto C, Zambon P, Guzzinati S, Finotti E, Costantini M (2008) Long-term outcome and risk of oesophageal cancer after surgery for achalasia. Br J Surg 95(12):1488–1494PubMedCrossRef Zaninotto G, Rizzetto C, Zambon P, Guzzinati S, Finotti E, Costantini M (2008) Long-term outcome and risk of oesophageal cancer after surgery for achalasia. Br J Surg 95(12):1488–1494PubMedCrossRef
34.
Zurück zum Zitat Meijssen MA, Tilanus HW, van Blankenstein M, Hop WC, Ong GL (1992) Achalasia complicated by oesophageal squamous cell carcinoma: a prospective study in 195 patients. Gut 33:155–158PubMedCrossRef Meijssen MA, Tilanus HW, van Blankenstein M, Hop WC, Ong GL (1992) Achalasia complicated by oesophageal squamous cell carcinoma: a prospective study in 195 patients. Gut 33:155–158PubMedCrossRef
35.
Zurück zum Zitat Csendes A, Braghetto I, Burdiles P, Korn O, Csendes P, Henriquez A (2006) Very late results of esophagomyotomy for patients with achalasia: clinical, endoscopic, histologic, manometric, and acid reflux studies in 67 patients for a mean follow-up of 190 months. Ann Surg 243(2):196–203PubMedCrossRef Csendes A, Braghetto I, Burdiles P, Korn O, Csendes P, Henriquez A (2006) Very late results of esophagomyotomy for patients with achalasia: clinical, endoscopic, histologic, manometric, and acid reflux studies in 67 patients for a mean follow-up of 190 months. Ann Surg 243(2):196–203PubMedCrossRef
36.
Zurück zum Zitat Patti MG, Diener U, Molena D (2001) Esophageal achalasia: preoperative assessment and postoperative follow-up. J Gastrointest Surg 5(1):11–12PubMedCrossRef Patti MG, Diener U, Molena D (2001) Esophageal achalasia: preoperative assessment and postoperative follow-up. J Gastrointest Surg 5(1):11–12PubMedCrossRef
37.
Zurück zum Zitat Moonka R, Patti MG, Feo CV et al (1999) Clinical presentation and evaluation of malignant pseudoachalasia. J Gastrointest Surg 3(5):456–461PubMedCrossRef Moonka R, Patti MG, Feo CV et al (1999) Clinical presentation and evaluation of malignant pseudoachalasia. J Gastrointest Surg 3(5):456–461PubMedCrossRef
38.
Zurück zum Zitat Howard PJ, Maher L, Pryde A, Cameron EW, Heading RC (1992) Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh. Gut 33(8):1011–1015PubMedCrossRef Howard PJ, Maher L, Pryde A, Cameron EW, Heading RC (1992) Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh. Gut 33(8):1011–1015PubMedCrossRef
39.
Zurück zum Zitat Patti MG, Herbella FA (2011) Achalasia and other esophageal motility disorders. J Gastrointest Surg 15(5):703–707PubMedCrossRef Patti MG, Herbella FA (2011) Achalasia and other esophageal motility disorders. J Gastrointest Surg 15(5):703–707PubMedCrossRef
40.
Zurück zum Zitat Woltman TA, Pellegrini CA, Oelschlager BK (2005) Achalasia. Surg Clin North Am 85(3):483–493PubMedCrossRef Woltman TA, Pellegrini CA, Oelschlager BK (2005) Achalasia. Surg Clin North Am 85(3):483–493PubMedCrossRef
41.
Zurück zum Zitat Eckardt VF, Stauf B, Bernhard G (1999) Chest pain in achalasia: patient characteristics and clinical course. Gastroenterology 116(6):1300–1304PubMedCrossRef Eckardt VF, Stauf B, Bernhard G (1999) Chest pain in achalasia: patient characteristics and clinical course. Gastroenterology 116(6):1300–1304PubMedCrossRef
42.
Zurück zum Zitat Sanderson DR, Ellis FH Jr, Schlegel JF, Olsen AM (1967) Syndrome of vigorous achalasia: clinical and physiologic observations. Dis Chest 52(4):508–517PubMedCrossRef Sanderson DR, Ellis FH Jr, Schlegel JF, Olsen AM (1967) Syndrome of vigorous achalasia: clinical and physiologic observations. Dis Chest 52(4):508–517PubMedCrossRef
43.
Zurück zum Zitat Pandolfino JE, Ghosh SK, Rice J, Clarke JO, Kwiatek MA, Kahrilas PJ (2008) Classifying esophageal motility by pressure topography characteristics: a study of 400 patients and 75 controls. Am J Gastroenterol 103(1):27–37PubMedCrossRef Pandolfino JE, Ghosh SK, Rice J, Clarke JO, Kwiatek MA, Kahrilas PJ (2008) Classifying esophageal motility by pressure topography characteristics: a study of 400 patients and 75 controls. Am J Gastroenterol 103(1):27–37PubMedCrossRef
44.
Zurück zum Zitat Pandolfino JE, Kwiatek MA, Nealis T, Bulsiewicz W, Post J, Kahrilas PJ (2008) Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology 135(5):1526–1533PubMedCentralPubMedCrossRef Pandolfino JE, Kwiatek MA, Nealis T, Bulsiewicz W, Post J, Kahrilas PJ (2008) Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology 135(5):1526–1533PubMedCentralPubMedCrossRef
45.
Zurück zum Zitat Salvador R, Costantini M, Zaninotto G et al (2010) The preoperative manometric pattern predicts the outcome of surgical treatment for esophageal achalasia. J Gastrointest Surg 14(11):1635–1645PubMedCrossRef Salvador R, Costantini M, Zaninotto G et al (2010) The preoperative manometric pattern predicts the outcome of surgical treatment for esophageal achalasia. J Gastrointest Surg 14(11):1635–1645PubMedCrossRef
46.
Zurück zum Zitat Vaezi MF, Richter JE (1998) Current therapies for achalasia: comparison and efficacy. J Clin Gastroenterol 27(1):21–35PubMedCrossRef Vaezi MF, Richter JE (1998) Current therapies for achalasia: comparison and efficacy. J Clin Gastroenterol 27(1):21–35PubMedCrossRef
47.
Zurück zum Zitat Gelfond M, Rozen P, Gilat T (1982) Isosorbide dinitrate and nifedipine treatment of achalasia: a clinical, manometric and radionuclide evaluation. Gastroenterology 83(5):963–969PubMed Gelfond M, Rozen P, Gilat T (1982) Isosorbide dinitrate and nifedipine treatment of achalasia: a clinical, manometric and radionuclide evaluation. Gastroenterology 83(5):963–969PubMed
48.
Zurück zum Zitat Gelfond M, Rozen P, Keren S, Gilat T (1981) Effect of nitrates on LOS pressure in achalasia: a potential therapeutic aid. Gut 22(4):312–318PubMedCrossRef Gelfond M, Rozen P, Keren S, Gilat T (1981) Effect of nitrates on LOS pressure in achalasia: a potential therapeutic aid. Gut 22(4):312–318PubMedCrossRef
49.
Zurück zum Zitat Rozen P, Gelfond M, Salzman S, Baron J, Gilat T (1982) Radionuclide confirmation of the therapeutic value of isosorbide dinitrate in relieving the dysphagia in achalasia. J Clin Gastroenterol 4(1):17–22PubMedCrossRef Rozen P, Gelfond M, Salzman S, Baron J, Gilat T (1982) Radionuclide confirmation of the therapeutic value of isosorbide dinitrate in relieving the dysphagia in achalasia. J Clin Gastroenterol 4(1):17–22PubMedCrossRef
50.
Zurück zum Zitat Traube M, Dubovik S, Lange RC, McCallum RW (1989) The role of nifedipine therapy in achalasia: results of a randomized, double-blind, placebo-controlled study. Am J Gastroenterol 84(10):1259–1262PubMed Traube M, Dubovik S, Lange RC, McCallum RW (1989) The role of nifedipine therapy in achalasia: results of a randomized, double-blind, placebo-controlled study. Am J Gastroenterol 84(10):1259–1262PubMed
51.
Zurück zum Zitat Bassotti G, Annese V (1999) Review article: pharmacological options in achalasia. Aliment Pharmacol Ther 13(11):1391–1396PubMedCrossRef Bassotti G, Annese V (1999) Review article: pharmacological options in achalasia. Aliment Pharmacol Ther 13(11):1391–1396PubMedCrossRef
52.
Zurück zum Zitat Pamphlett R (1989) Early terminal and nodal sprouting of motor axons after botulinum toxin. J Neurol Sci 92(2–3):181–192PubMedCrossRef Pamphlett R (1989) Early terminal and nodal sprouting of motor axons after botulinum toxin. J Neurol Sci 92(2–3):181–192PubMedCrossRef
53.
Zurück zum Zitat Sweet MP, Nipomnick I, Gasper WJ et al (2008) The outcome of laparoscopic heller myotomy for achalasia is not influenced by the degree of esophageal dilatation. J Gastrointest Surg 12(1):159–165PubMedCrossRef Sweet MP, Nipomnick I, Gasper WJ et al (2008) The outcome of laparoscopic heller myotomy for achalasia is not influenced by the degree of esophageal dilatation. J Gastrointest Surg 12(1):159–165PubMedCrossRef
54.
Zurück zum Zitat Bassotti G, D’Onofrio V, Battaglia E et al (2006) Treatment with botulinum toxin of octo-nonagerians with oesophageal achalasia: a two-year follow-up study. Aliment Pharmacol Ther 23(11):1615–1619PubMedCrossRef Bassotti G, D’Onofrio V, Battaglia E et al (2006) Treatment with botulinum toxin of octo-nonagerians with oesophageal achalasia: a two-year follow-up study. Aliment Pharmacol Ther 23(11):1615–1619PubMedCrossRef
55.
Zurück zum Zitat Chuah SK, Wu KL, Hu TH, Tai WC, Changchien CS (2010) Endoscope-guided pneumatic dilation for treatment of esophageal achalasia. World J Gastroenterol 16(4):411–417PubMedCrossRef Chuah SK, Wu KL, Hu TH, Tai WC, Changchien CS (2010) Endoscope-guided pneumatic dilation for treatment of esophageal achalasia. World J Gastroenterol 16(4):411–417PubMedCrossRef
56.
Zurück zum Zitat Katzka DA, Castell DO (2011) Review article: an analysis of the efficacy, perforation rates and methods used in pneumatic dilation for achalasia. Aliment Pharmacol Ther 34(8):832–839PubMedCrossRef Katzka DA, Castell DO (2011) Review article: an analysis of the efficacy, perforation rates and methods used in pneumatic dilation for achalasia. Aliment Pharmacol Ther 34(8):832–839PubMedCrossRef
57.
Zurück zum Zitat Weber CE, Davis CS, Kramer HJ, Gibbs JT, Robles L, Fisichella PM (2012) Medium and long-term outcomes after pneumatic dilation or laparoscopic heller myotomy for achalasia: a meta-analysis. Surg Laparosc Endosc Percutan Tech 22(4):289–296PubMedCrossRef Weber CE, Davis CS, Kramer HJ, Gibbs JT, Robles L, Fisichella PM (2012) Medium and long-term outcomes after pneumatic dilation or laparoscopic heller myotomy for achalasia: a meta-analysis. Surg Laparosc Endosc Percutan Tech 22(4):289–296PubMedCrossRef
58.
Zurück zum Zitat Tuset JA, Lujan M, Huguet JM, Canelles P, Medina E (2009) Endoscopic pneumatic balloon dilation in primary achalasia: predictive factors, complications, and long-term follow-up. Dis Esophagus 22(1):74–79PubMedCrossRef Tuset JA, Lujan M, Huguet JM, Canelles P, Medina E (2009) Endoscopic pneumatic balloon dilation in primary achalasia: predictive factors, complications, and long-term follow-up. Dis Esophagus 22(1):74–79PubMedCrossRef
59.
Zurück zum Zitat Inoue H, Minami H, Kobayashi Y et al (2010) Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy 42(4):265–271PubMedCrossRef Inoue H, Minami H, Kobayashi Y et al (2010) Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy 42(4):265–271PubMedCrossRef
60.
Zurück zum Zitat von Renteln D, Inoue H, Minami H et al (2012) Peroral endoscopic myotomy for the treatment of achalasia: a prospective single center study. Am J Gastroenterol 107(3):411–417CrossRef von Renteln D, Inoue H, Minami H et al (2012) Peroral endoscopic myotomy for the treatment of achalasia: a prospective single center study. Am J Gastroenterol 107(3):411–417CrossRef
61.
Zurück zum Zitat Ren Z, Zhong Y, Zhou P et al (2012) Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases). Surg Endosc 26(11):3267–3272PubMedCrossRef Ren Z, Zhong Y, Zhou P et al (2012) Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases). Surg Endosc 26(11):3267–3272PubMedCrossRef
62.
Zurück zum Zitat Swanstrom LL, Kurian A, Dunst CM, Sharata A, Bhayani N, Rieder E (2012) Long-term outcomes of an endoscopic myotomy for achalasia: the POEM procedure. Ann Surg 256(4):659–667PubMedCrossRef Swanstrom LL, Kurian A, Dunst CM, Sharata A, Bhayani N, Rieder E (2012) Long-term outcomes of an endoscopic myotomy for achalasia: the POEM procedure. Ann Surg 256(4):659–667PubMedCrossRef
63.
Zurück zum Zitat Heller E (1913) Kardiaplastik beim chronischen kardiospasmus mit dilatation des oesophagus. Mitt Grenzgeb Med Chir 27:141–149 Heller E (1913) Kardiaplastik beim chronischen kardiospasmus mit dilatation des oesophagus. Mitt Grenzgeb Med Chir 27:141–149
64.
Zurück zum Zitat Shimi S, Nathanson LK, Cuschieri A (1991) Laparoscopic cardiomyotomy for achalasia. J R Coll Surg Edinb 36(3):152–154PubMed Shimi S, Nathanson LK, Cuschieri A (1991) Laparoscopic cardiomyotomy for achalasia. J R Coll Surg Edinb 36(3):152–154PubMed
65.
Zurück zum Zitat Patti MG, Pellegrini CA, Horgan S et al (1999) Minimally invasive surgery for achalasia: an 8-year experience with 168 patients. Ann Surg 230(4):587–593 (discussion 593–594) Patti MG, Pellegrini CA, Horgan S et al (1999) Minimally invasive surgery for achalasia: an 8-year experience with 168 patients. Ann Surg 230(4):587–593 (discussion 593–594)
66.
Zurück zum Zitat Richards WO, Torquati A, Holzman MD et al (2004) Heller myotomy versus heller myotomy with dor fundoplication for achalasia: a prospective randomized double-blind clinical trial. Ann Surg 240(3):405–412 (discussion 412–415) Richards WO, Torquati A, Holzman MD et al (2004) Heller myotomy versus heller myotomy with dor fundoplication for achalasia: a prospective randomized double-blind clinical trial. Ann Surg 240(3):405–412 (discussion 412–415)
67.
Zurück zum Zitat Burpee SE, Mamazza J, Schlachta CM et al (2005) Objective analysis of gastroesophageal reflux after laparoscopic heller myotomy: an anti-reflux procedure is required. Surg Endosc 19(1):9–14PubMedCrossRef Burpee SE, Mamazza J, Schlachta CM et al (2005) Objective analysis of gastroesophageal reflux after laparoscopic heller myotomy: an anti-reflux procedure is required. Surg Endosc 19(1):9–14PubMedCrossRef
68.
Zurück zum Zitat Kjellin AP, Granqvist S, Ramel S, Thor KB (1999) Laparoscopic myotomy without fundoplication in patients with achalasia. Eur J Surg 165(12):1162–1166PubMedCrossRef Kjellin AP, Granqvist S, Ramel S, Thor KB (1999) Laparoscopic myotomy without fundoplication in patients with achalasia. Eur J Surg 165(12):1162–1166PubMedCrossRef
69.
Zurück zum Zitat Oelschlager BK, Chang L, Pellegrini CA (2003) Improved outcome after extended gastric myotomy for achalasia. Arch Surg 138(5):490–495 (discussion 495–497) Oelschlager BK, Chang L, Pellegrini CA (2003) Improved outcome after extended gastric myotomy for achalasia. Arch Surg 138(5):490–495 (discussion 495–497)
70.
Zurück zum Zitat Liebermann-Meffert D, Allgöwer M, Schmid P, Blum AL (1979) Muscular equivalent of the lower esophageal sphincter. Gastroenterology 76:31–38PubMed Liebermann-Meffert D, Allgöwer M, Schmid P, Blum AL (1979) Muscular equivalent of the lower esophageal sphincter. Gastroenterology 76:31–38PubMed
71.
Zurück zum Zitat Mattioli S, Pilotti V, Felice V, DiSimone M, D’Ovidio F, Gozzetti G (1993) Intraoperative study on the relationship between the lower esophageal sphincter pressure and the muscular components of the gastro-esophageal junction in achalasic patients. Ann Surg 218:635–639PubMedCrossRef Mattioli S, Pilotti V, Felice V, DiSimone M, D’Ovidio F, Gozzetti G (1993) Intraoperative study on the relationship between the lower esophageal sphincter pressure and the muscular components of the gastro-esophageal junction in achalasic patients. Ann Surg 218:635–639PubMedCrossRef
72.
Zurück zum Zitat Boeckxstaens GE, Annese V, des Varannes SB et al (2011) Pneumatic dilation versus laparoscopic Heller’s myotomy for idiopathic achalasia. N Engl J Med 364(19):1807–1816PubMedCrossRef Boeckxstaens GE, Annese V, des Varannes SB et al (2011) Pneumatic dilation versus laparoscopic Heller’s myotomy for idiopathic achalasia. N Engl J Med 364(19):1807–1816PubMedCrossRef
73.
Zurück zum Zitat Patti MG, Pellegrini CA (2012) Esophageal achalasia 2011: pneumatic dilatation or laparoscopic myotomy? J Gastrointest Surg 16(4):870–873PubMedCrossRef Patti MG, Pellegrini CA (2012) Esophageal achalasia 2011: pneumatic dilatation or laparoscopic myotomy? J Gastrointest Surg 16(4):870–873PubMedCrossRef
74.
Zurück zum Zitat Chen Z, Bessell JR, Chew A, Watson DI (2010) Laparoscopic cardiomyotomy for achalasia: clinical outcomes beyond 5 years. J Gastrointest Surg 14(4):594–600PubMedCrossRef Chen Z, Bessell JR, Chew A, Watson DI (2010) Laparoscopic cardiomyotomy for achalasia: clinical outcomes beyond 5 years. J Gastrointest Surg 14(4):594–600PubMedCrossRef
75.
Zurück zum Zitat Malthaner RA, Tood TR, Miller L, Pearson FG (1994) Long-term results in surgically managed esophageal achalasia. Ann Thorac Surg 58(5):1343–1346 (discussion 1346–1347) Malthaner RA, Tood TR, Miller L, Pearson FG (1994) Long-term results in surgically managed esophageal achalasia. Ann Thorac Surg 58(5):1343–1346 (discussion 1346–1347)
76.
Zurück zum Zitat Gaissert HA, Lin N, Wain JC, Fankhauser G, Wright CD, Mathisen DJ (2006) Transthoracic heller myotomy for esophageal achalasia: analysis of long-term results. Ann Thorac Surg 81(6):2044–2049PubMedCrossRef Gaissert HA, Lin N, Wain JC, Fankhauser G, Wright CD, Mathisen DJ (2006) Transthoracic heller myotomy for esophageal achalasia: analysis of long-term results. Ann Thorac Surg 81(6):2044–2049PubMedCrossRef
77.
Zurück zum Zitat Vela MF, Richter JE, Khandwala F et al (2006) The long-term efficacy of pneumatic dilatation and heller myotomy for the treatment of achalasia. Clin Gastroenterol Hepatol 4(5):580–587PubMedCrossRef Vela MF, Richter JE, Khandwala F et al (2006) The long-term efficacy of pneumatic dilatation and heller myotomy for the treatment of achalasia. Clin Gastroenterol Hepatol 4(5):580–587PubMedCrossRef
78.
Zurück zum Zitat Patti MG, Molena D, Fisichella PM et al (2001) Laparoscopic heller myotomy and dor fundoplication for achalasia: analysis of successes and failures. Arch Surg 136(8):870–877PubMedCrossRef Patti MG, Molena D, Fisichella PM et al (2001) Laparoscopic heller myotomy and dor fundoplication for achalasia: analysis of successes and failures. Arch Surg 136(8):870–877PubMedCrossRef
79.
Zurück zum Zitat Molena D, Yang SC (2012) Surgical management of end-stage achalasia. Semin Thorac Cardiovasc Surg 24(1):19–26PubMedCrossRef Molena D, Yang SC (2012) Surgical management of end-stage achalasia. Semin Thorac Cardiovasc Surg 24(1):19–26PubMedCrossRef
80.
Zurück zum Zitat Patti MG, Feo CV, Diener U et al (1999) Laparoscopic heller myotomy relieves dysphagia in achalasia when the esophagus is dilated. Surg Endosc 13(9):843–847PubMedCrossRef Patti MG, Feo CV, Diener U et al (1999) Laparoscopic heller myotomy relieves dysphagia in achalasia when the esophagus is dilated. Surg Endosc 13(9):843–847PubMedCrossRef
81.
Zurück zum Zitat Hirota WK, Zuckerman MJ, Adler DG et al (2006) ASGE guideline: the role of endoscopy in the surveillance of premalignant conditions of the upper GI tract. Gastrointest Endosc 63(4):570–580PubMedCrossRef Hirota WK, Zuckerman MJ, Adler DG et al (2006) ASGE guideline: the role of endoscopy in the surveillance of premalignant conditions of the upper GI tract. Gastrointest Endosc 63(4):570–580PubMedCrossRef
82.
Metadaten
Titel
The management of esophageal achalasia: from diagnosis to surgical treatment
verfasst von
Adrian Dobrowolsky
P. Marco Fisichella
Publikationsdatum
01.03.2014
Verlag
Springer Milan
Erschienen in
Updates in Surgery / Ausgabe 1/2014
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-013-0224-1

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