Clinical Characteristics and Treatment Outcomes of 3 Subtypes of Achalasia According to the Chicago Classification in a Tertiary Institute in Korea.
- Author:
Ju Yup LEE
1
;
Nayoung KIM
;
Sung Eun KIM
;
Yoon Jin CHOI
;
Kyu Keun KANG
;
Dong Hyun OH
;
Hee Jin KIM
;
Kwung Jun PARK
;
A Young SEO
;
Hyuk YOON
;
Cheol Min SHIN
;
Young Soo PARK
;
Jin Hyeok HWANG
;
Jin Wook KIM
;
Sook Hyang JEONG
;
Dong Ho LEE
Author Information
1. Department of Internal Medicine, Seoul National University, Bundang Hospital, Seongnam, Gyeonggi-do, Korea. nayoungkim49@empas.com
- Publication Type:Original Article
- Keywords:
Esophageal achalasia;
Esophageal motility disorders;
Manometry
- MeSH:
Dilatation;
Esophageal Achalasia*;
Esophageal Motility Disorders;
Esophagus;
Follow-Up Studies;
Humans;
Korea*;
Manometry
- From:Journal of Neurogastroenterology and Motility
2013;19(4):485-494
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Achalasia is classified into 3 types according to the Chicago classification. The aim of this study was to investigate characteristics and treatment outcomes of 3 achalasia subtypes in Korean patients. METHODS: Fifty-five patients diagnosed with achalasia based on conventional or high-resolution esophageal manometry were consecutively enrolled. Their clinical characteristics, manometric, endoscopic and esophagographic findings and treatment responses were analyzed among the 3 subtypes of achalasia. RESULTS: Of 55 patients, 21 (38.2%) patients had type I, 28 (50.9%) patients had type II and 6 (10.9%) patients had type III. The median follow-up period was 22.4 (interquartile range, 3.6-67.4) months. Type III patients were older than type I and II patients (70.0 vs. 46.2 and 47.6 years, P = 0.023). The width of the esophagus in type I patients was wider with more frequent bird's beak appearance on esophagogram than the other 2 types (P = 0.010 and 0.006, respectively). Of the 50 patients who received the evaluation for treatment response at 3 months, 7 patients (36.8% vs. 26.9%) were treated with pneumatic dilatation and 4 patients (21.1% vs. 15.4%) with laparoscopic Heller's myotomy in type I and II groups, respectively. The treatment responses of pneumatic dilatation and Heller's myotomy in type I group were 71.4 and 50.0% and in type II were 85.7 and 75.0%, respectively, and all 5 patients in type III group showed good response to medical therapy. CONCLUSIONS: Clinical characteristics of 3 achalasia subtypes in Korean patients are consistent with other studies. Treatment outcomes are variable among 3 subtypes.
