DIFFERENT ENDOSCOPIC TREATMENT OPTIONS IN THE MANAGEMENT OF ACHALASIA
DOI:
https://doi.org/10.21638/11701/spbu11.2016.203Abstract
In this article, we showed the optimal examination schedule in patients with suspected achalasia. The
diagnostic algorithm of achalasia included X-ray, multispiral computed tomography (MSCT) of the chest and upper abdomen and endoscopic examination methods. All these methods allowed for establishing the exact diagnosis and precise stage of the disease. Th e most common classifi cation for achalasia staging in the Russian Federation is the classifi cation proposed by Petrovskiy B. V. in 1962 which is based on the interpretation of X-ray imaging results because of their simplicity and availability. In this study we also showed diff erent treatment options such as an endoscopic balloon pneumatic dilation used to relieve the obstruction by mechanical disrupting, botulinum toxin injection directed to reduce pressure of the lower esophageal sphincter, minimally invasive interventions with pharmacological therapy, and surgical treatment for patients with IV stage of the disease that may benefi t in 98,2% of those patients. Additionally we showed clinical results of an absolutely new treatment method of endoscopic managing achalasia in the Russian Federation: oral esophageal myotomy (POEM) used in our clinic since 2014. It is a promising and minimally invasive option for treating achalasia. However, it still requires more data and assessment of clinical effi cacy. Refs 19. Figs 8.
Keywords:
Achalasia, endoscopic balloon pneumatic dilation, botulinum toxin injection, peroral endoscopic myotomy (POEM)
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References
Литература
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Park W., Vaezi M. F. Etiology and pathogenesis of achalasia the current understanding. Am. J. Gastroenterol., 2005 Jun, vol. 100 (6), pp. 1404–1414.
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Hungness E. Per oral Endoscopic Myotomy (POEM): Achalasia — Treatment optios and Expected oucomes. SAGES PG Course, 2012.
Von Renteln D., Inoue H., Minami H., Werner Y. B., Pace A., Kersten J. F., Much C. C., Schachschal G.,Mann O., Keller J., Fuchs K. H. Rsch T. Peroral endoscopic myotomy for the treatment of achalasia: a prospective single center study. Am. J. Gastroenterol., 2012 Mar, vol. 107(3), pp. 411–417.
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Published
2016-10-07
How to Cite
Королев, М. П., Федотов, Л. Е., Спесивцев, Ю. А., Оглоблин, А. Л., Смирнов, А. А., Мамедов, Ш. Д. о., & Конанов, Е. В. (2016). DIFFERENT ENDOSCOPIC TREATMENT OPTIONS IN THE MANAGEMENT OF ACHALASIA. Vestnik of Saint Petersburg University. Medicine, 11(2), 20–28. https://doi.org/10.21638/11701/spbu11.2016.203
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Surgery
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Articles of "Vestnik of Saint Petersburg University. Medicine" are open access distributed under the terms of the License Agreement with Saint Petersburg State University, which permits to the authors unrestricted distribution and self-archiving free of charge.
