Oesophageal achalasia: an argument for primary surgical management.

Hdl Handle:
http://hdl.handle.net/10147/127607
Title:
Oesophageal achalasia: an argument for primary surgical management.
Authors:
Leonard, D S; Broe, P
Affiliation:
Department of Surgery Beaumont Hospital, Dublin, Ireland. leonarddavid@eircom.net
Citation:
Oesophageal achalasia: an argument for primary surgical management. 2009, 7 (2):101-13 Surgeon
Journal:
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Issue Date:
Apr-2009
URI:
http://hdl.handle.net/10147/127607
PubMed ID:
19408803
Abstract:
Achalasia is a primary oesophageal motility disorder resulting from damage to the ganglion cells of the myenteric plexus. Impaired relaxation of the lower oesophageal sphincter and aperistalsis causes its cardinal symptoms of dysphagia, chest pain and reflux-type symptoms. Management is somewhat controversial, with options including systemic and local pharmacotherapy, dilatation and oesophagomyotomy. We review the presentation, investigation and management of oesophageal achalasia and make an argument for primary surgical management.; We performed a Medline search of the term 'achalasia', limiting the search to clinical trials and meta-analyses. We then selected articles based on their abstracts using four main criteria: previously unreported findings, previously unreported techniques, size of patient cohort and journal impact factor. References in selected articles were manually searched for other relevant articles.; Achalasia has been managed using a variety of techniques including systemic and local pharmacotherapy, forced dilatation and oesophagomyotomy. Success rates vary widely between techniques. Mechanical disruption ofthe lower oesophageal sphincter is most successful.; In achalasia, mechanical disruption of the lower oesophageal sphincter using forced dilatation or surgical myotomy offers the only realistic prospect of long-term symptom relief. Recent evidence suggests that previous medical treatment or dilatation makes oesophagomyotomy more difficult and increases the risk of complications. As the morbidity associated with surgery continues to decrease with improvements in minimal access techniques, the argument for primary management of achalasia with oesophagomyotomy becomes more compelling.
Item Type:
Article
Language:
en
MeSH:
Dilatation; Endoscopy; Esophageal Achalasia; Esophageal Sphincter, Lower; Humans
ISSN:
1479-666X

Full metadata record

DC FieldValue Language
dc.contributor.authorLeonard, D Sen
dc.contributor.authorBroe, Pen
dc.date.accessioned2011-04-07T08:01:32Z-
dc.date.available2011-04-07T08:01:32Z-
dc.date.issued2009-04-
dc.identifier.citationOesophageal achalasia: an argument for primary surgical management. 2009, 7 (2):101-13 Surgeonen
dc.identifier.issn1479-666X-
dc.identifier.pmid19408803-
dc.identifier.urihttp://hdl.handle.net/10147/127607-
dc.description.abstractAchalasia is a primary oesophageal motility disorder resulting from damage to the ganglion cells of the myenteric plexus. Impaired relaxation of the lower oesophageal sphincter and aperistalsis causes its cardinal symptoms of dysphagia, chest pain and reflux-type symptoms. Management is somewhat controversial, with options including systemic and local pharmacotherapy, dilatation and oesophagomyotomy. We review the presentation, investigation and management of oesophageal achalasia and make an argument for primary surgical management.-
dc.description.abstractWe performed a Medline search of the term 'achalasia', limiting the search to clinical trials and meta-analyses. We then selected articles based on their abstracts using four main criteria: previously unreported findings, previously unreported techniques, size of patient cohort and journal impact factor. References in selected articles were manually searched for other relevant articles.-
dc.description.abstractAchalasia has been managed using a variety of techniques including systemic and local pharmacotherapy, forced dilatation and oesophagomyotomy. Success rates vary widely between techniques. Mechanical disruption ofthe lower oesophageal sphincter is most successful.-
dc.description.abstractIn achalasia, mechanical disruption of the lower oesophageal sphincter using forced dilatation or surgical myotomy offers the only realistic prospect of long-term symptom relief. Recent evidence suggests that previous medical treatment or dilatation makes oesophagomyotomy more difficult and increases the risk of complications. As the morbidity associated with surgery continues to decrease with improvements in minimal access techniques, the argument for primary management of achalasia with oesophagomyotomy becomes more compelling.-
dc.language.isoenen
dc.subject.meshDilatation-
dc.subject.meshEndoscopy-
dc.subject.meshEsophageal Achalasia-
dc.subject.meshEsophageal Sphincter, Lower-
dc.subject.meshHumans-
dc.titleOesophageal achalasia: an argument for primary surgical management.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery Beaumont Hospital, Dublin, Ireland. leonarddavid@eircom.neten
dc.identifier.journalThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Irelanden
dc.description.provinceLeinster-

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