贲门失弛缓症
医学
食管运动障碍
食道痉挛
高分辨率测压
肌切开术
内科学
回流
胃肠病学
蠕动
食管
运动性
食管疾病
食管胃交界处
疾病
吞咽困难
癌症
腺癌
作者
Fernando A. M. Herbella,L Grande,Francisco Schlottmann,Marco G. Patti
标识
DOI:10.1007/s12325-021-01714-w
摘要
The Chicago Classification is the most used classification for primary esophageal motility disorders (PEMD). This classification was recently updated to the 4.0 version. This opinion piece focuses on the possible implications for the treatment of PMED determined by the new classification. Chicago Classification 4.0 included two new concepts for the diagnosis of achalasia: (1) type III achalasia diagnosis demands 100% absent peristalsis defined as either failed peristalsis or spasm; (2) “inconclusive diagnosis of achalasia” was added as a possibility. Both may decrease unnecessary treatment. Esophagogastric junction outflow obstruction, distal esophageal spasm, and hypercontractile esophagus were only considered clinically significant when correlated to supportive testing and relevant clinical symptoms and in the absence of gastroesophageal reflux disease. This may decrease the surge of treatment, especially peroral endoscopic myotomy, based solely on manometric diagnosis.
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