Marco G Patti1, Francisco Schlottmann2,3, Fernando A M Herbella4. 1. Department of Surgery, University of Virginia, Charlottesville, VA, USA. 2. Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA. 3. Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina. 4. Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo, SP, 04037-003, Brazil. herbella.dcir@epm.br.
Abstract
BACKGROUND: Esophageal achalasia is a primary esophageal motility disorder of unknown origin. Treatment is palliative and its goal is to decrease the resistance posed by a non-relaxing and often hypertensive lower esophageal sphincter. This goal can be accomplished by different treatment modalities such as pneumatic dilatation, laparoscopic myotomy or peroral endoscopic myotomy. In some patients, however, symptoms tend to recur overtime. METHODS: A comprehensive literature search was performed on PubMed focused on the management of recurrent achalasia. RESULTS: The available treatment modalities can be used, alone or in combination. The goal of treatment is to resolve/improve symptoms, avoiding an esophagectomy, an operation linked to significant morbidity. CONCLUSIONS: The treatment of these patients is often very challenging, and the best results are obtained in centers where a multidisciplinary team-radiologists, gastroenterologists, and surgeons-is present.
BACKGROUND: Esophageal achalasia is a primary esophageal motility disorder of unknown origin. Treatment is palliative and its goal is to decrease the resistance posed by a non-relaxing and often hypertensive lower esophageal sphincter. This goal can be accomplished by different treatment modalities such as pneumatic dilatation, laparoscopic myotomy or peroral endoscopic myotomy. In some patients, however, symptoms tend to recur overtime. METHODS: A comprehensive literature search was performed on PubMed focused on the management of recurrent achalasia. RESULTS: The available treatment modalities can be used, alone or in combination. The goal of treatment is to resolve/improve symptoms, avoiding an esophagectomy, an operation linked to significant morbidity. CONCLUSIONS: The treatment of these patients is often very challenging, and the best results are obtained in centers where a multidisciplinary team-radiologists, gastroenterologists, and surgeons-is present.
Authors: Pietro Familiari; Giovanni Gigante; Michele Marchese; Ivo Boskoski; Andrea Tringali; Vincenzo Perri; Guido Costamagna Journal: Ann Surg Date: 2016-01 Impact factor: 12.969
Authors: H Inoue; H Minami; Y Kobayashi; Y Sato; M Kaga; M Suzuki; H Satodate; N Odaka; H Itoh; S Kudo Journal: Endoscopy Date: 2010-03-30 Impact factor: 10.093
Authors: Guy E Boeckxstaens; Vito Annese; Stanislas Bruley des Varannes; Stanislas Chaussade; Mario Costantini; Antonello Cuttitta; J Ignasi Elizalde; Uberto Fumagalli; Marianne Gaudric; Wout O Rohof; André J Smout; Jan Tack; Aeilko H Zwinderman; Giovanni Zaninotto; Olivier R Busch Journal: N Engl J Med Date: 2011-05-12 Impact factor: 91.245
Authors: Fraukje A Ponds; Paul Fockens; Aaltje Lei; Horst Neuhaus; Torsten Beyna; Jennis Kandler; Thomas Frieling; Philip W Y Chiu; Justin C Y Wu; Vivien W Y Wong; Guido Costamagna; Pietro Familiari; Peter J Kahrilas; John E Pandolfino; André J P M Smout; Albert J Bredenoord Journal: JAMA Date: 2019-07-09 Impact factor: 56.272
Authors: Yuki B Werner; Bengt Hakanson; Jan Martinek; Alessandro Repici; Burkhard H A von Rahden; Albert J Bredenoord; Raf Bisschops; Helmut Messmann; Marius C Vollberg; Tania Noder; Jan F Kersten; Oliver Mann; Jakob Izbicki; Alexander Pazdro; Uberto Fumagalli; Riccardo Rosati; Christoph-Thomas Germer; Marlies P Schijven; Alice Emmermann; Daniel von Renteln; Paul Fockens; Guy Boeckxstaens; Thomas Rösch Journal: N Engl J Med Date: 2019-12-05 Impact factor: 91.245