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| 1 | Data analyses and perspectives on laparoscopic surgery for esophageal achalasia显示文摘In general,the treatment methods for esophageal achalasia are largely classified into four groups,including drug therapy using nitrite or a calcium channel blocker,botulinum toxin injection,endoscopic therapy such as endoscopic balloon dilation,and surgery. Various studies have suggested that the most effective treatment of esophageal achalasia is surgical therapy. The basic concept of this surgical therapy has not changed since Heller proposed esophageal myotomy for the purpose of resolution of lower esophageal obstruction for the first time in 1913,but the most common approach has changed from openchest surgery to laparoscopic surgery. Currently,the laparoscopic surgery has been the procedure of choice for the treatment of esophageal achalasia. During the process of the transition from open-chest surgery to laparotomy,to thoracoscopic surgery,and to laparoscopic surgery,the necessity of combining antireflux surgery has been recognized. There is some debate as to which type of antireflux surgery should be selected. The Toupet fundoplication may be the most effective in prevention of postoperative antireflux,but many medical institutions have selected the Dor fundoplication which covers the mucosal surface exposed by myotomy. Recently,a new endoscopic approach,peroral endoscopic myotomy(POEM),has received attention. Future studies should examine the long-term outcomes and whether POEM becomes the gold standard for the treatment of esophageal achalasia. | Kazuto Tsuboi Nobuo Omura Fumiaki Yano Masato Hoshino Se-Ryung Yamamoto Shunsuke Akimoto Takahiro Masuda Hideyuki Kashiwagi Katsuhiko Yanaga | 2015 | World Journal of Gastroenterology2015，21，38： | 1 |
| 2 | Can high resolution manometry parameters for achalasia be obtained by conventional manometry?显示文摘High resolution manometry(HRM) is a new technology that made important contributions to the field of gastrointestinal physiology. HRM showed clear advan-tages over conventional manometry and it allowed the creation of different manometric parameters. On the other side, conventional manometry is still wild available. It must be better studied if the new technology made possible the creation and study of these parameters or if they were always there but the colorful intuitive panoramic view of the peristalsis from the pharynx to the stomach HRM allowed the human eyes to distinguish subtle parameters unknown or uncomprehend so far and if HRM parameters can be reliably obtained by conventional manometry and data from conventional manometry still can be accepted in achalasia studies. Conventional manometry relied solely on the residual pressure to evaluate lower esophageal sphincter(LES) relaxation while HRM can obtain the Integrated Relaxation Pressure. Esophageal body HRM parameters defines achalasia subtypes, the Chicago classification, based on esophageal pressurization after swallows. The characterization of each subtype is very intuitive by HRM but also easy by conventional manometry since only wave amplitudes need to be measured. In conclusion, conventional manometry is still valuable to classify achalasia according to the Chicago classification. HRM permits a better study of the LES. | Fernando AM Herbella Marco G Patti | 2015 | World Journal of Gastrointestinal Pathophysiology2015，6，3： | 0 |
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