Journal of Okayama Medical Association
Published by Okayama Medical Association

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食道アカラシアバルーン拡張術およびHeller-Dor手術施行後の下部食道運動異常に対しPOEM(peroral endoscopic myotomy)が著効した1 例

Sugihara, Yuusaku Department of Gastroenterology and Hepatology, Okayama University Hospital
Harada, Keita Department of Gastroenterology and Hepatology, 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
Yamasaki, Yasushi Department of Gastroenterology and Hepatology, Okayama University Hospital
Inokuchi, 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
Manabe, Noriaki Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School
Otsuka, Fumio Department of General Medicine, Okayama University Hospital
Okada, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Hospital
Abstract
Esophageal achalasia is a disorder of the lower esophageal sphincter muscle. Our patient, a Japanese male in his 80's, had been experiencing dysphagia for almost 60 years. He was treated with balloon dilations and Heller-Dor 5 years prior to his present admission. Esophagogastroduodenoscopy, esophageal radiography, and high-myotomy manometry indicated that the symptoms were likely due to abnormal peristalsis. With the patient’s informed consent, we performed a peroral endoscopic myotomy(POEM). The patient was discharged 4 days post-surgery. At the 6-month postoperative examination, no worsening of symptoms or relapse was observed. POEM is an excellent treatment method for esophageal achalasia from the perspective of therapeutic effect. We recommend that POEM be considered as the first-choice treatment for abnormal peristalsis after a Heller-Dor myotomy.
Keywords
POEM(peroral endoscopic myotomy)
食道アカラシア(esophageal achalasia)
Note
症例報告 (Case Report)
ISSN
0030-1558
NCID
AN00032489
DOI
NAID