An effective case of peroral endoscopic myotomy for esophageal abnormal peristalsis after Heller-Dor myotomy

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  • Sugihara Yuusaku
    Department of Gastroenterology and Hepatology, Okayama University Hospital Department of General Medicine, 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

Bibliographic Information

Other Title
  • 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
  • 症例報告 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
  • ショウレイ ホウコク ショクドウ アカラシアバルーン カクチョウジュツ オヨビ Heller-Dor シュジュツ シコウ ゴ ノ カブ ショクドウ ウンドウ イジョウ ニ タイシ POEM(peroral endoscopic myotomy)ガ チョコウシタ 1レイ

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Description

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.

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