TITLE

The Value of Scoring Achalasia: A Comparison of Current Systems and the Impact on Treatment--The Surgeon's Viewpoint

AUTHOR(S)
Gockel, I.; Junginger, Th.
PUB. DATE
April 2007
SOURCE
American Surgeon;Apr2007, Vol. 73 Issue 4, p327
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Heller myotomy in patients with achalasia promises better long-term success than pneumatic dilation, especially in younger patients, and therefore has evolved as the primary treatment option. The aim of this study was to evaluate the impact of different disease-specific severity scores on achalasia treatment. Fifty consecutive patients undergoing pneumatic dilation (n = 25) or myotomy (n = 25) were assessed pre- and postinterventionally by clinical evaluation using the Eckardt Score, the Vantrappen Classification, and the Adams's Stages, as well as by radiologic and manometric studies and by subjective evaluation. The Eckardt Score and the Vantrappen Classification correlated significantly with each other. The Eckardt Score, because of its widest range and interval-level measurement properties converting the score to the Eckardt Stages, tends toward being the most useful system for clinical practice. The indication for myotomy or dilation therapy can not be set by a specific cut-off point in any system and remains an individual decision, including the aspects of the patient's age and failed prior options.
ACCESSION #
24627583

 

Related Articles

  • Achalasia of the Esophagus. Liebman, William M.; Applebaum, Michael; Thaler, M. Michael // American Journal of Gastroenterology;Jul1978, Vol. 70 Issue 1, p73 

    A four-year old boy with achalasia of the esophagus was successfully treated with pneumatic dilatation, using the standard Browne-McHardy dilator, without incident. His subsequent course over 10 months has been uneventful.

  • Fatal Heart Block Following Treatment With Botulinum Toxin for Achalasia. Malnick, Stephen D. H.; Metchnik, Laura; Somin, Marina; Bergman, Nina; Attali, Malka // American Journal of Gastroenterology;Nov2000, Vol. 95 Issue 11, p3333 

    Reports on the case of a patient with achalasia who developed a fatal heart block after receiving an injection of botulinum toxin. Medical history of the patient; Result of the patient's esophagogastroduodenoscopy; Mechanism of action of botulinum toxin.

  • Treatment of Achalasia When the Heller Operation has Failed. Palmer, Eddy D. // American Journal of Gastroenterology;Mar1972, Vol. 57 Issue 3, p255 

    Provides information on achalasia and the treatment for achalasia when the Heller cardiomyotomy operation has failed. Cause of cardiospasm; Presence of esophagitis in chronic achalasia cases; Reason for the recurrence of achalasia after a Heller cardiomyotomy operation.

  • Achalasia with Suppurative Pericarditis. French, T.; Kench, P.; Swanepoel, A.; Hewitson, R.; Gelb, A. // American Journal of Gastroenterology;Dec1974, Vol. 62 Issue 6, p536 

    Presents a case of a patient with achalasia of the esophagus with suppurative pericarditis. Medical analysis of the patient; Medical treatment done on the patient; Study findings.

  • CUTTING EDGE MANAGEMENT OF ACHALASIA. Hinder, Ronald A.; Napoliello, David A.; Klingler, Paul J. // American Journal of Gastroenterology;Jul1997, Vol. 92 Issue 7, p1078 

    Describes the multiple modalities available for the management of achalasia. Drug therapy for the relaxation of the lower esophageal sphincter; Success rate of forced balloon dilation as permanent treatment of achalasia; Examination of other techniques in treating achalasia.

  • A Prospective Assessment of Gastroesophageal Reflux before and after Treatment of Achalasia Patients: Pneumatic Dilation Versus Transthoracic Limited Myotomy. Shoenut, J. Patrick; Duerksen, Donald; Yaffe, Clifford S. // American Journal of Gastroenterology;Jul1997, Vol. 92 Issue 7, p1109 

    Objectives: We conducted this study to determine whether reflux should be a major consideration in the choice of treatment for achalasia patients. Achalasia patients undergoing either pneumatic dilation or transthoracic limited esophagomyotomy were monitored for reflux before and after...

  • ACHALASIA MANAGEMENT: DIFFICULT NO MATTER HOW YOU SLICE IT! Clement, Donald J.; Johnson, David // American Journal of Gastroenterology;Mar1998, Vol. 93 Issue 3, p478 

    Discusses research on achalasia management. Reference to a study by J. G. Hunter et al., published in a 1997 issue of the journal "Annals of Surgery"; Study procedure; Study findings.

  • Esophageal Diverticula.  // Diseases & Disorders: A Nursing Therapeutics Manual, 3rd edition;2007, p337 

    The article presents a nursing guide to esophageal diverticula or herniations of the esophageal mucosa. It discusses the causes, assessment, diagnosis and treatment of the disease. It describes the genetic, racial and ethnic characteristics of the people most susceptible to this disease....

  • Treatment of Achalasia: The Best of Both Worlds. Abid, S.; Champion, G.; Richter, J. E.; McElvein, R.; Slaughter, R. L.; Koehler, R. E. // American Journal of Gastroenterology;Jul1994, Vol. 89 Issue 7, p979 

    Objective: To conduct a retrospective analysis of one center's experience with treating achalasia over 4 yr with skilled gastroenterologists using primarily the Rigiflex balloon dilator and with a senior surgeon performing Heller myotomies. Methods: Newly diagnosed cases of achalasia were...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics