Arora Zubin, Thota Prashanthi N, Sanaka Madhusudhan R
Department of Gastroenterology and Hepatology, Cleveland Clinic, OH, USA.
Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH 44195, USA.
Ther Adv Chronic Dis. 2017 Jun;8(6-7):101-108. doi: 10.1177/2040622317710010. Epub 2017 Jun 23.
Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia. Management of achalasia mainly involves improving the esophageal outflow in order to provide symptomatic relief to patients. The most effective treatment options for achalasia include pneumatic dilation, Heller myotomy and peroral endoscopic myotomy (POEM), with the latter increasingly emerging as the treatment of choice for many patients. This review focusses on evidence for current and emerging treatment options for achalasia with a particular emphasis on POEM.
贲门失弛缓症是一种慢性不可治愈的食管动力障碍性疾病，其特征为食管下括约肌（LES）松弛受损和食管蠕动丧失。尽管罕见，但它是目前最常见的原发性食管动力障碍性疾病，年发病率约为每10万人中1.6例，患病率约为每10万人中10.8例。贲门失弛缓症的症状包括吞咽固体和液体困难、反流、误吸、胸痛和体重减轻。由于贲门失弛缓症的潜在病因仍不清楚，目前尚无治愈该疾病的方法。贲门失弛缓症的治疗主要包括改善食管流出道，以缓解患者症状。贲门失弛缓症最有效的治疗选择包括气囊扩张、Heller肌切开术和经口内镜下肌切开术（POEM），后者越来越多地成为许多患者的首选治疗方法。本综述重点关注贲门失弛缓症现有和新兴治疗选择的证据，特别强调POEM。
