岡山医学会雑誌
Online ISSN : 1882-4528
Print ISSN : 0030-1558
症例報告
食道アカラシアバルーン拡張術およびHeller-Dor手術施行後の下部食道運動異常に対しPOEM(peroral endoscopic myotomy)が著効した1 例
杉原 雄策原田 馨太加藤 諒山内 健司髙嶋 志保山崎 泰史井口 俊博高原 政宏川野 誠司平岡 佐規子眞部 紀明大塚 文男岡田 裕之
著者情報
キーワード: POEM, 食道アカラシア
ジャーナル フリー

2018 年 130 巻 2 号 p. 67-71

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 Esophageal achalasia is a disorder of the lower esophageal sphincter muscle. Our patient, a Japanese male in his 80's, had been experiencing dysphagia for almost 60 years. He was treated with balloon dilations and Heller-Dor 5 years prior to his present admission. Esophagogastroduodenoscopy, esophageal radiography, and high-myotomy manometry indicated that the symptoms were likely due to abnormal peristalsis. With the patient’s informed consent, we performed a peroral endoscopic myotomy(POEM). The patient was discharged 4 days post-surgery. At the 6-month postoperative examination, no worsening of symptoms or relapse was observed. POEM is an excellent treatment method for esophageal achalasia from the perspective of therapeutic effect. We recommend that POEM be considered as the first-choice treatment for abnormal peristalsis after a Heller-Dor myotomy.
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