Copyright
©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 25, 2016; 8(2): 30-39
Published online Jan 25, 2016. doi: 10.4253/wjge.v8.i2.30
Published online Jan 25, 2016. doi: 10.4253/wjge.v8.i2.30
Endoscopic treatment of esophageal achalasia
Dario Esposito, Francesco Maione, Alessandra D’Alessandro, Giovanni Sarnelli, Giovanni D De Palma, Department of Clinical Medicine and Surgery, University of Naples Federico II, School of Medicine, 80131 Naples, Italy
Giovanni D De Palma, Center of Excellence for Technical Innovation in Surgery, University of Naples Federico II, School of Medicine, 80131 Naples, Italy
Author contributions: Esposito D, Maione F, D’Alessandro A, Sarnelli G and De Palma GD were all equally responsible for the design, conception, drafting, and final approval of this paper.
Conflict-of-interest statement: Dario Esposito, Francesco Maione, Alessandra D’Alessandro, Giovanni Sarnelli and Giovanni D De Palma have nothing to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giovanni D De Palma, MD, Director of Center of Excellence for Technical Innovation in Surgery, Department of Clinical Medicine and Surgery, University of Naples Federico II, School of Medicine, via Pansini 5, 80131 Napoli, Italy. giovanni.depalma@unina.it
Telephone: +39-81-7462773 Fax: +39-81-7462752
Received: June 27, 2015
Peer-review started: June 29, 2015
First decision: August 16, 2015
Revised: November 26, 2015
Accepted: December 13, 2015
Article in press: December 15, 2015
Published online: January 25, 2016
Peer-review started: June 29, 2015
First decision: August 16, 2015
Revised: November 26, 2015
Accepted: December 13, 2015
Article in press: December 15, 2015
Published online: January 25, 2016
Core Tip
Core tip: Achalasia is characterized by dysphagia, regurgitation, chest pain, weight loss and respiratory symptoms. Diagnosis and post-treatment assessment largely rely upon endoscopy, barium swallow study and high resolution esophageal manometry (HRM). Short term improvement in the symptomatology can be achieved with medical therapy or endoscopic botulin toxin injection. Long term relief from dysphagia can be obtained with either laparoscopic Heller myotomy, pneumatic dilatation or per-oral endoscopic myotomy. Age, sex, and manometric subtype by HRM are also predictors of responsiveness to treatment. Self-expandable metallic stents are an alternative in patients non responding to conventional therapies.