Gastroesophageal reflux following per-oral endoscopic myotomy:Can we improve outcomes?  

作　　者：Inian Samarasam Raj Kumar Joel Anna B Pulimood 

机构地区：[1]Department of Surgery,Upper Gastrointestinal Surgery Unit,Christian Medical College&Hospital,Vellore 632004,Tamilnadu,India [2]Department of Cardiothoracic Surgery,Christian Medical College&Hospital,Vellore 632004,Tamilnadu,India [3]Department of Gastrointestinal Sciences,Christian Medical College and Hospital,Vellore 632004,Tamil Nadu,India

出　　处：《World Journal of Gastroenterology》2024年第22期2834-2838,共5页世界胃肠病学杂志（英文版）

摘　　要：This editorial is an analysis the review article by Nabi et al recently published in this journal.Achalasia Cardia is a disease whose pathophysiology is still unclear.It is known that there is inflammation of unknown aetiology leading to loss of ganglion cells in the muscularis propria.The end result is lower oesophageal sphincter spasm,loss of receptive relaxation,decreased oesophageal peristalsis,all leading on to varying degrees of dysphagia.The treatment of this condition is palliative in nature,performed by myotomy of the lower oesophagus either surgically or endoscopically.Gastroesophageal reflux disease(GERD)has been associated with the myotomy performed,particularly with the Peroral Endoscopic Myotomy(POEM)procedure.Nabi et al have provided an excellent overview of the latest developments in predicting,preventing,evaluating,and managing GERD subsequent to POEM.Based on this theme,this review article explores the concept of using histology of the oesophageal muscle layer,to grade the disease and thereby help tailoring the length/type of myotomy performed during the POEM procedure.In the future,will a histology based algorithm available preoperatively,help modify the POEM procedure,thereby decreasing the incidence of GERD associated with POEM?

关 键 词：Achalasia cardia Peroral endoscopic myotomy Laparoscopic Heller’s myotomy HISTOPATHOLOGY Histologic grading 

分 类 号：R655.4[医药卫生—外科学]