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KMID : 1812020130190040485
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Journal of Neurogastroenterology and Motility
2013 Volume.19 No. 4 p.485 ~ p.494
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Clinical Characteristics and Treatment Outcomes of 3 Subtypes of Achalasia According to the Chicago Classification in a Tertiary Institute in Korea
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Abstract
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Background/Aims Achalasia is classified into 3 types according to the Chicago classification. The aim of this study was to investigate character-istics and treatment outcomes of 3 achalasia subtypes in Korean patients. Methods Fifty-five patients diagnosed with achalasia based on conventional or high-resolution esophageal manometry were consecuti-vely enrolled. Their clinical characteristics, manometric, endoscopic and esophagographic findings and treatment responses were analyzed among the 3 subtypes of achalasia. Results Of 55 patients, 21 (38.2%) patients had type I, 28 (50.9%) patients had type II and 6 (10.9%) patients had type III. The me-dian follow-up period was 22.4 (interquartile range, 3.6-67.4) months. Type III patients were older than type I and II patients (70.0 vs. 46.2 and 47.6 years, P = 0.023). The width of the esophagus in type I patients was wider with more frequent bird’s beak appearance on esophagogram than the other 2 types (P = 0.010 and 0.006, respectively). Of the 50 patients who re-ceived the evaluation for treatment response at 3 months, 7 patients (36.8% vs. 26.9%) were treated with pneumatic dilatation and 4 patients (21.1% vs. 15.4%) with laparoscopic Heller’s myotomy in type I and II groups, respectively. The treatment re-sponses of pneumatic dilatation and Heller’s myotomy in type I group were 71.4 and 50.0% and in type II were 85.7 and 75.0%, respectively, and all 5 patients in type III group showed good response to medical therapy. Conclusions Clinical characteristics of 3 achalasia subtypes in Korean patients are consistent with other studies. Treatment outcomes are variable among 3 subtypes.
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KEYWORD
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Esophageal achalasia, Esophageal motility disorders, Manometry
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