童年 achalasia : 疾病，诊断和治疗学的管理的全面评论

• 作者: Ashanti L Franklin Mikael Petrosyan Timothy D Kane
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: ACHALASIA PEDIATRICS Surgical HELLER MYOTOMY Balloon DILATATION Lower esophageal SPHINCTER
• 年，卷（期）: 2014,（4）
• 页码范围: 105-111
• 页数: 7页
• 分类号: R726.5

摘要

Achalasia is an esophageal motility disorder character-ized by failure of lower esophageal sphincter(LES) relaxation and is rare in children. The most common symptoms are vomiting, dysphagia, regurgitation, and weight loss. Definitive diagnosis is made with barium swallow study and esophageal manometry. In adults, endoscopic biopsy is recommended to exclude malig-nancy however; it is not as often indicated in children. Medical management often fails resulting in recurrent symptoms and the ultimate definitive treatment is sur-gical. Laparoscopic Heller myotomy with or without an anti-reflux procedure is the treatment of choice and has become standard of care for children with achala-sia. Peroral endoscopic myotomy is a novel therapy uti-lized with increasing frequency for achalasia treatment in adults. More experience is needed to determine the safety, efficacy, and feasibility of peroral endoscopic myotomy in children.