贲门失弛缓症与食管裂孔疝：一种罕见的关联及治疗挑战。

Achalasia and Hiatal Hernia: A Rare Association and a Therapeutic Challenge.

作者信息

Tutuian Georgiana, Leandri Chloé, Tutuian Radu, Scialom Sophie, Leconte Mahaut, Dohan Anthony, Coriat Romain, Chaussade Stanislas, Barret Maximilien

机构信息

Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.

Department of Gastroenterology and Hepatology, Bürgerspital Solothurn, Solothurn, Switzerland.

出版信息

J Neurogastroenterol Motil. 2023 Oct 30;29(4):455-459. doi: 10.5056/jnm22151. Epub 2023 Aug 27.

DOI:10.5056/jnm22151

PMID:37634895

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10577465/

Abstract

BACKGROUND/AIMS: Achalasia and hiatal hernia are rarely associated. The aim of the current study is to explore the clinical and manometric findings in patients with achalasia and hiatal hernia, and to determine if the presence of a hiatal hernia should influence therapeutic management in patients with achalasia.

METHODS

This retrospective single center analysis included a group of patients with achalasia and hiatal hernia (study group) and a group of matched patients with achalasia but no hiatal hernia (control group). We recorded demographic, clinical, endoscopic, and manometric parameters and compared initial presentation and treatment outcomes between the groups.

RESULTS

Between 2015 and 2022, achalasia was diagnosed in 294/1513 (19.4%) patients. Concomitant hiatal hernia was identified in 13/294 (4.4%) patients. Compared to patients with achalasia and no hiatal hernia, patients in the study group had lower Eckardt scores at baseline (5.4 ± 2.0 vs 7.8 ± 2.4; = 0.005) but similar integrated relaxation pressure. Following treatment, patients in the study and control group had similar clinical success and prevalence of gastroesophageal reflux symptoms.

CONCLUSIONS

Hiatal hernia is rarely associated with achalasia. The presence of a hiatal hernia should not influence treatment decisions in patients with achalasia.

摘要

背景/目的：贲门失弛缓症与食管裂孔疝很少相关。本研究的目的是探讨贲门失弛缓症合并食管裂孔疝患者的临床和测压结果，并确定食管裂孔疝的存在是否应影响贲门失弛缓症患者的治疗管理。

方法

这项回顾性单中心分析纳入了一组贲门失弛缓症合并食管裂孔疝的患者（研究组）和一组匹配的无食管裂孔疝的贲门失弛缓症患者（对照组）。我们记录了人口统计学、临床、内镜和测压参数，并比较了两组之间的初始表现和治疗结果。

结果

2015年至2022年期间，1513例患者中有294例（19.4%）被诊断为贲门失弛缓症。其中13例（4.4%）患者合并食管裂孔疝。与无食管裂孔疝的贲门失弛缓症患者相比，研究组患者基线时的埃卡特评分较低（5.4±2.0对7.8±2.4；P = 0.005），但综合松弛压相似。治疗后，研究组和对照组患者的临床成功率和胃食管反流症状患病率相似。