Achalasia and Hiatal Hernia: A Rare Association and a Therapeutic Challenge.

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neurogastroenterology and Motility Pub Date : 2023-10-30 Epub Date: 2023-08-27 DOI:10.5056/jnm22151

Georgiana Tutuian, Chloé Leandri, Radu Tutuian, Sophie Scialom, Mahaut Leconte, Anthony Dohan, Romain Coriat, Stanislas Chaussade, Maximilien Barret

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引用次数: 0

Abstract

Background/aims: Achalasia and hiatal hernia are rarely associated. The aim of the current study is to explore the clinical and manometric findings in patients with achalasia and hiatal hernia, and to determine if the presence of a hiatal hernia should influence therapeutic management in patients with achalasia.

Methods: This retrospective single center analysis included a group of patients with achalasia and hiatal hernia (study group) and a group of matched patients with achalasia but no hiatal hernia (control group). We recorded demographic, clinical, endoscopic, and manometric parameters and compared initial presentation and treatment outcomes between the groups.

Results: Between 2015 and 2022, achalasia was diagnosed in 294/1513 (19.4%) patients. Concomitant hiatal hernia was identified in 13/294 (4.4%) patients. Compared to patients with achalasia and no hiatal hernia, patients in the study group had lower Eckardt scores at baseline (5.4 ± 2.0 vs 7.8 ± 2.4; P = 0.005) but similar integrated relaxation pressure. Following treatment, patients in the study and control group had similar clinical success and prevalence of gastroesophageal reflux symptoms.

Conclusions: Hiatal hernia is rarely associated with achalasia. The presence of a hiatal hernia should not influence treatment decisions in patients with achalasia.

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贲门失弛缓症和先天性疝：罕见的关联和治疗挑战。

背景/目的：贲门失弛缓症和裂孔疝很少相关。本研究的目的是探讨贲门失弛缓症和裂孔疝患者的临床和测压结果，并确定裂孔疝的存在是否会影响贲门失弛弛缓症患者的治疗管理。方法：本回顾性单中心分析包括一组贲门失弛缓症和裂孔疝患者（研究组）和一组匹配的贲门失弛弛缓症但无裂孔疝的患者（对照组）。我们记录了人口统计学、临床、内镜和测压参数，并比较了两组之间的初始表现和治疗结果。结果：2015年至2022年间，294/1513名（19.4%）患者被诊断为贲门失弛缓症。合并裂孔疝的患者有13/294例（4.4%）。与贲门失弛缓症和无裂孔疝的患者相比，研究组患者在基线时的Eckardt评分较低（5.4±2.0 vs 7.8±2.4；P=0.005），但综合舒张压相似。治疗后，研究组和对照组患者的临床成功率和胃食管反流症状的发生率相似。结论：先天性疝很少与贲门失弛缓症相关。食管裂孔疝的存在不应影响贲门失弛缓症患者的治疗决定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurogastroenterology and Motility GASTROENTEROLOGY & HEPATOLOGY-CLINICAL NEUROLOGY

CiteScore

6.30

自引率

8.80%

发文量

期刊介绍： Journal of Neurogastroenterology and Motility (J Neurogastroenterol Motil) is a joint official journal of the Korean Society of Neurogastroenterology and Motility, the Thai Neurogastroenterology and Motility Society, the Japanese Society of Neurogastroenterology and Motility, the Indian Motility and Functional Disease Association, the Chinese Society of Gastrointestinal Motility, the South East Asia Gastro-Neuro Motility Association, the Taiwan Neurogastroenterology and Motility Society and the Asian Neurogastroenterology and Motility Association, launched in January 2010 after the title change from the Korean Journal of Neurogastroenterology and Motility, published from 1994 to 2009.