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논문 기본 정보

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학술저널
저자정보
Hong Jin Yoon (Department of Internal Medicine Gangnam Severance Hospital Yonsei University College of Medicine Se) Jeung Eun Lee (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Da Hyun Jung (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Jun Chul Park (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Young Hoon Youn (Department of Internal Medicine Gangnam Severance Hospital Yonsei University College of Medicine Se) Hyojin Park (Department of Internal Medicine Gangnam Severance Hospital Yonsei University College of Medicine Se)
저널정보
대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.26 No.1
발행연도
2020.1
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67 - 73 (7page)

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Background/Aims: Achalasia is a chronic, progressive motility disorder of the esophagus. The sigmoid-type achalasia is an advanced stage of achalasia characterized by severe dilatation and tortuous angulation of the esophageal body. Peroral endoscopic myotomy (POEM) has been reported to provide excellent clinical outcomes for achalasia, including the sigmoid type, but the restoration of esophageal morphology and function remain poorly described. The aim of our study is to investigate esophageal restoration after POEM for sigmoid-type achalasia. Methods: From 98 patients with achalasia who underwent POEM in the Yonsei University Health System from 2013 to 2018, we recruited 13 patients with sigmoid-type achalasia (7 male; mean age 53.3 years) and assessed morphological and manometric changes in the esophagus. Results: Clinical success (Eckardt score < 3) was achieved in all cases. After POEM, the average angle of esophageal tortuosity became more obtuse (91.5° vs 114.6°, P = 0.046), esophageal body diameter decreased (67.6 vs 49.8 mm, P = 0.002), and esophagogastric junction opening widened (6.4 vs 9.5 mm, P = 0.048). Patients whose esophageal tortuosity did not improve had longer durations of symptoms than patients with improvement (80.2 vs 636 months, P < 0.001). An absence of peristalsis was observed in all patients pre- and post-POEM. Conclusions: POEM resulted in excellent clinical outcomes and morphologic improvement in sigmoid-type achalasia. These results suggest that the improvement of esophageal tortuosity through POEM reflects a reduced esophageal burden.
#Esophageal achalasia #Myotomy #Peroral endoscopic myotomy #Sigmoid-type achalasia

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참고문헌 (23)

참고문헌 신청
O’Neill OM / 2013 / Achalasia : a review of clinical diagnosis, epidemiology, treatment and outcomes / World J Gastroenterol 19:5806~5812 google schola Howard JM / 2011 / Oesophagectomy in the management of end-stage achalasia-case reports and a review of the literature / Int J Surg 9:204~208 google schola Devaney EJ / 2001 / Esophagectomy for achalasia : patient selection and clinical experience / Ann Thorac Surg 72:854~858 google schola Panchanatheeswaran K / 2013 / Laparoscopic Heller’s cardiomyotomy : a viable treatment option for sigmoid oesophagus / Interact Cardiovasc Thorac Surg 16:49~54 google schola Gunasingam N / 2016 / Update on therapeutic interventions for the management of achalasia / J Gastroenterol Hepatol 31:1422~1428 google schola

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