Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.

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

杉原 雄策 岡山大学病院 消化器内科
原田 馨太 岡山大学病院 光学医療診療部 ORCID
加藤 諒 岡山大学病院 消化器内科
山内 健司 岡山大学病院 消化器内科
高嶋 志保 岡山大学病院 消化器内科
竹井 大介 岡山大学病院 光学医療診療部
井口 俊博 岡山大学病院 消化器内科
高原 政宏 岡山大学病院 消化器内科
川野 誠司 岡山大学病院 消化器内科
平岡 佐規子 岡山大学病院 消化器内科
田辺 俊介 岡山大学病院 消化管外科
野間 和宏 岡山大学病院 消化管外科
白川 靖博 岡山大学病院 消化管外科 ORCID Kaken ID publons
眞部 紀明 川崎医科大学 検査診断学
井上 晴洋 昭和大学江東豊洲病院 消化器センター
岡田 裕之 岡山大学病院 消化器内科 Kaken ID publons researchmap
129_115.pdf 34.9 MB
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.
食道アカラシア (esophageal achalasia)
症例報告(Case Reports)