Journal of Okayama Medical Association
Published by Okayama Medical Association

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POEM (Per-Oral Endoscopic Myotomy) を施行した 食道アカラシアの1例

Sugihara, Yuusaku Department of Gastroenterology and Hepatology, Okayama University Hospital
Harada, Keita Division of Endoscopy, Okayama University Hospital
Kato, Ryo Department of Gastroenterology and Hepatology, Okayama University Hospital
Yamauchi, Kenji Department of Gastroenterology and Hepatology, Okayama University Hospital
Takashima, Shiho Department of Gastroenterology and Hepatology, Okayama University Hospital
Takei, Daisuke Division of Endoscopy, Okayama University Hospital
Inokuchia, Toshihiro Department of Gastroenterology and Hepatology, Okayama University Hospital
Takahara, Masahiro Department of Gastroenterology and Hepatology, Okayama University Hospital
Kawano, Seiji Department of Gastroenterology and Hepatology, Okayama University Hospital
Hiraoka, Sakiko Department of Gastroenterology and Hepatology, Okayama University Hospital
Tanabe, Shunsuke Department of Gastroenterological Surgery, Okayama University Hospital
Noma, Kazuhiro Department of Gastroenterological Surgery, Okayama University Hospital
Shirakawa, Yasuhiro Department of Gastroenterological Surgery, Okayama University Hospital
Manabe, Noriaki Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School
Inoue, Haruhiro Digestive Diseases Center, Showa University Koto Toyosu Hospital
Okada, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Hospital Kaken ID researchmap
Abstract
Esophageal achalasia is a disorder of the lower esophageal sphincter muscle. Patients present with dysphagia, chest pain, vomiting, and aspiration. Esophageal achalasia had traditionally been treated with esophageal achalasia balloon dilatation and the Heller-Dor method, but in recent years, the use of per-oral endoscopic myotomy (POEM) has increased. Our patient, a 39-yr-old male, began experiencing dysphagia 4 years prior to his referral to our hospital. Based on the results of esophagogastroduodenoscopy, esophageal radiography and high-resolution manometry, we made the diagnosis of esophageal achalasia (Chicago classification type I) . After informed consent from the patient and his family and approval from our hospital's ethics committee were obtained, we performed a POEM. The patient was discharged on the 4th day post-surgery. At the 1-year post-operative examination, no worsening of symptoms and no relapse were observed. POEM is an excellent treatment method for esophageal achalasia from the perspective of therapeutic effect and prevention of invasion. We recommend that it be considered as the first-choice treatment for achalasia. However, accessibility to the procedure itself is limited due to the few adequately trained operators worldwide. POEM should thus be performed by an expert operator at a high-volume center.
Keywords
POEM
食道アカラシア (esophageal achalasia)
Note
症例報告(Case Reports)
ISSN
0030-1558
NCID
AN00032489
DOI