ACCUEIL

Consignes aux
auteurs et coordonnateurs
Nos règles d'éthique
Autres revues >>

ACTA Endoscopica

0240-642X
Revue officielle de la Société Française d'Endoscopie Digestive
Vous êtes sur le site des articles parus entre 1971 et 2014 :
» Accédez aux articles parus depuis 2015 «
 

 ARTICLE VOL 36/4 - 2006  - pp.561-570  - doi:10.1007/BF03003759
TITRE
Traitement de l’achalasie de l’œsophage

TITLE
Treatment of oesophageal achalasia

ABSTRACT

Idiopathic achalasia is an affliction with well defined radiological and manometric clinical criteria, although atypical or intermediary forms with diffuse oesophageal spasm have been described. The etiology is unknown but progress has been made regarding the understanding of the physiopathological mechanisms — involvement of the NO mediated inhibitory pathway — and physiopathology. Ganglionitis with lymphocytic infiltration is perhaps related to a herpes group virus. The observation of a serum factor altering the functioning of human myenteric neurons by the Nantes team raises the possibility of an etiological treatment aimed at dysimmune mechanisms. Until an etiological target is found, treatment consists of removing the distal functional obstacle. Myorelaxants, and particularly nifedipine, should be proposed in the early forms and in elderly subjects. Botulinum toxin is disappointing in retrospect. It is useful in vigorous achalasia, in elderly subjects. Pneumatic dilation and coelioscopic Heller myotomy are treatments that aim at a definitive result. The endoscopic as well as surgical procedural variants render comparisons difficult. A European study comparing progressive pneumatic dilation to coelioscopic myotomy with Dorr valve is underway. The long term results of these two therapies are less than expected and justify regular monitoring of patients for treatment of stasis oesophagitis, reflux, endobrachyoesophagus and the risk of carcinoma.



AUTEUR(S)
E.H. METMAN, L. NEGREANU, Sonia DEBBABI

KEYWORDS
botulinum toxin, Heller myotomy, idiopathic achalasia, pneumatic dilation

LANGUE DE L'ARTICLE
Français

 PRIX
• Abonné (hors accès direct) : 34.95 €
• Non abonné : 34.95 €
|
|
--> Tous les articles sont dans un format PDF protégé par tatouage 
   
ACCÉDER A L'ARTICLE COMPLET  (1,13 Mo)



Mot de passe oublié ?

ABONNEZ-VOUS !

CONTACTS
Comité de
rédaction
Conditions
générales de vente

 English version >> 
Lavoisier