Return of Peristalsis After Myotomy for Achalasia?

Partial recovery of peristalsis did occur after laparoscopic or endoscopic myotomy in more than half of patients, but larger studies are needed.

In patients with achalasia, the primary goal of myotomy is to relieve the obstruction at the dysfunctional lower esophageal sphincter. Whether the procedure also restores peristalsis is controversial.

To assess this issue, investigators conducted a retrospective study of 30 patients with achalasia who underwent laparoscopic or endoscopic myotomy at two tertiary-care hospitals. According to Chicago classification criteria, 8 patients (27%) had type 1 achalasia (absence of contractile activity and pressurization), 17 (57%) had type 2 (panesophageal pressurization), and 5 (17%) had type 3 (premature contractions). High-resolution manometry was performed before and after myotomy to measure contractions and pressure in the lower esophagus.

Before …

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors