Strategies for treating severe refractory dysphagia.
Traditional treatment of achalasia, pneumatic dilatation or surgical myotomy, results in satisfactory relief of dysphagia in 85% to 90% of patients. Unfortunately, a small percentage of patients do not respond to these therapies or remain refractory, often because of a severely dilated or sigmoid esophagus. Esophagectomy, with gastric pull up or color interposition, is the procedure of choice in these patients, which can result in satisfactory relief of dysphagia with minimal mortality. This article reviews the strategies for management of achalasia patients with refractory dysphagia.
Khazanchi
A
A
Department of Gastroenterology, Graduate Hospital, Philadelphia, Pennsylvania 19146, USA.
Katz
P O
PO
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D003680:Deglutition Disorders / Q000209:etiology* / Q000628:therapy*; D004106:Dilatation; D004931:Esophageal Achalasia / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D016629:Esophagectomy; D005500:Follow-Up Studies; D006801:Humans; D009130:Muscle, Smooth / Q000601:surgery; D009465:Neuromuscular Agents / Q000627:therapeutic use; D018579:Patient Selection; D012720:Severity of Illness Index; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A