| Title |
A Controversy That Has Been Tough to Swallow: Is the Treatment of Achalasia Now Digested?
|
|---|---|
| Published in |
Journal of Gastrointestinal Surgery, September 2009
|
| DOI | 10.1007/s11605-009-1013-5 |
| Pubmed ID | |
| Authors |
Garrett R. Roll, Charlotte Rabl, Ruxandra Ciovica, Sofia Peeva, Guilherme M. Campos |
| Abstract |
Esophageal achalasia is a rare neurodegenerative disease of the esophagus and the lower esophageal sphincter that presents within a spectrum of disease severity related to progressive pathological changes, most commonly resulting in dysphagia. The pathophysiology of achalasia is still incompletely understood, but recent evidence suggests that degeneration of the postganglionic inhibitory nerves of the myenteric plexus could be due to an infectious or autoimmune mechanism, and nitric oxide is the neurotransmitter affected. Current treatment of achalasia is directed at palliation of symptoms. Therapies include pharmacological therapy, endoscopic injection of botulinum toxin, endoscopic dilation, and surgery. Until the late 1980s, endoscopic dilation was the first line of therapy. The advent of safe and effective minimally invasive surgical techniques in the early 1990s paved the way for the introduction of laparoscopic myotomy. This review will discuss the most up-to-date information regarding the pathophysiology, diagnosis, and treatment of achalasia, including a historical perspective. The laparoscopic Heller myotomy with partial fundoplication performed at an experienced center is currently the first line of therapy because it offers a low complication rate, the most durable symptom relief, and the lowest incidence of postoperative gastroesophageal reflux. |
Mendeley readers
The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 2 | 6% |
| Mexico | 1 | 3% |
| Unknown | 31 | 91% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 6 | 18% |
| Professor | 4 | 12% |
| Researcher | 3 | 9% |
| Other | 3 | 9% |
| Student > Master | 3 | 9% |
| Other | 9 | 26% |
| Unknown | 6 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 26 | 76% |
| Computer Science | 1 | 3% |
| Unknown | 7 | 21% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 December 2014.
All research outputs
#20,656,820
of 25,374,917 outputs
Outputs from Journal of Gastrointestinal Surgery
#1,818
of 2,485 outputs
Outputs of similar age
#98,224
of 107,052 outputs
Outputs of similar age from Journal of Gastrointestinal Surgery
#13
of 13 outputs
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