Nieponice Alejandro, Nachman Fabio, Badaloni Adolfo, Ciotola Franco, Zubieta Cecilia, Ramirez Mauricio
Esophageal Institute, Hospital Universitario Fundacion Favaloro, Buenos Aires, Argentina.
J Thorac Dis. 2017 Jul;9(Suppl 8):S681-S688. doi: 10.21037/jtd.2017.05.61.
Achalasia and Treatment of esophageal Adenocarcinoma are commonly associated to surgical resection. Newer technologies in interventional endoscopy gave way to a substantial paradigm shift in the management of these conditions. In the case of achalasia, endoscopic myotomy is rapidly displacing Heller's myotomy as the gold standard in many centers. Early stage neoplasia in Barrett's esophagus (BE) comprising high-grade dysplasia (HGD), intramucosal and, in some cases, submucosal carcinoma is now being treated without the need of esophagectomy. This review presents a summary of the most relevant endoscopic techniques for both achalasia and esophageal cancer. Endoscopic advances in diagnostic and therapeutic arenas allow for minimally invasive therapies and organ preservation in most settings of achalasia and early stage neoplasia of the esophagus provided that the clinical setting and physician's expertise are prepared for this approach.
贲门失弛缓症和食管腺癌的治疗通常与手术切除相关。介入性内镜检查的新技术使这些疾病的管理发生了重大的模式转变。在贲门失弛缓症的情况下，内镜下肌切开术在许多中心正迅速取代海勒肌切开术成为金标准。巴雷特食管（BE）中的早期肿瘤，包括高级别异型增生（HGD）、黏膜内癌以及某些情况下的黏膜下癌，现在无需进行食管切除术即可得到治疗。本综述总结了贲门失弛缓症和食管癌最相关的内镜技术。诊断和治疗领域的内镜进展使得在大多数贲门失弛缓症和食管早期肿瘤的情况下能够进行微创治疗并保留器官，前提是临床情况和医生的专业知识为此方法做好了准备。
