The value of high resolution manometry to evaluate clinical characteristics and esophageal dynamic of patients with achalasia
10.3760/cma.j.issn.1007-5232.2017.08.006
- VernacularTitle:高分辨率测压评价贲门失弛缓症患者临床和食管动力学特征的研究
- Author:
Fandong MENG
1
;
Wenyan LI
;
Qiaozhi ZHOU
;
Ming JI
;
Yongdong WU
;
Peng LI
;
Yongjun WANG
;
Li YU
;
Yinglin NIU
Author Information
1. 国家消化系统疾病临床医学研究中心 首都医科大学附属北京友谊医院消化内科
- Keywords:
Esophageal achalasia;
Manometry;
Peroral endoscopic myotomy;
Pneumatic dilation
- From:
Chinese Journal of Digestive Endoscopy
2017;34(8):563-567
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical and esophageal dynamics characteristics, and initial treatment effect of patients with untreated achalasia using high resolution manometry. Methods From January 2012 to June 2016, patients newly diagnosed with achalasia were retrospectively recruited. Clinical information, endoscopy and X-ray findings, manometric variables and treatment outcomes were collected and compared among manometric subtypes. Results Among 133 patients with achalasia, 32 ( 24. 0%) were classified as type Ⅰ, 84 ( 63. 2%) as typeⅡ and 17 ( 12. 8%) as typeⅢ. Compared with the typeⅢ, the symptom of regurgitation was more common in the types I and typeⅡachalasia patients ( P=0. 020) . While compared with the type Ⅰ, the score of chest pain was higher in the patients with type Ⅱ and type Ⅲ ( P=0. 006) , as well as the basal lower esophageal sphincter pressure ( P=0. 015, P=0. 023 for type Ⅱ and type Ⅲ, respectively) . Integrated relaxation pressure was similar among the 3 subtypes ( P=0. 158) . Forty-five and 47 patients received pneumatic dilation ( PD ) and peroral endoscopic myotomy ( POEM ) respectively, and all of the patients were followed-up for at least 6 months. The success rate was higher in the POEM group than that of the PD group in all the 3 manometric subtypes, but only the difference between POEM and PD in the type Ⅲ was statistically significant ( 90. 0% VS 40. 0%, P = 0. 041 ) . Conclusion The clinical characteristics and treatment response are different among the 3 achalasia subtypes. Patients with type Ⅲ achalasia are probably the best candidates for POEM.
