キシノ　マイコ   KISHINO Maiko   岸野　真衣子    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Clinical presentation and therapeutic outcome of patients with jackhammer esophagus-a multicenter cohort study in Japan.
掲載誌名	正式名：Esophagus : official journal of the Japan Esophageal Society 略　 称：Esophagus ISSNコード：16129067/16129059
掲載区分	国外
巻・号・頁	19(3),pp.393-400
著者・共著者	HOSAKA Hiroko, KAWAMI Noriyuki, MANABE Noriaki, KURIBAYASHI Shiko, SATO Hiroki, FUNAKI Yasushi, AYAKI Maki, HARA Ken, UEDA Chise, MATSUMURA Tomoaki, FUJIWARA Yasuhiro, WADA Masafumi, KISHINO Maiko, YANO Fumiaki, MASAOKA Tatsuhiro, ISHIMURA Norihisa, AKIYAMA Junichi, OCHIAI Yorinari, URAOKA Toshio, IWAKIRI Katsuhiko
発行年月	2022/07
概要	BACKGROUND:Jackhammer esophagus (JE) is a hypercontractile esophageal motility disorder diagnosed using high-resolution manometry (HRM). We sought to determine the clinical presentation and therapeutic data of patients with JE in Japan.METHODS:The study included patients with JE, diagnosed through HRM performed for suspicious esophageal motility disorders. Demographics, esophagogastroduodenoscopy, radiology, and therapy data were collected from patient charts.RESULTS:Among the 4,412 HRM tests performed, 89 patients (61.6 ± 13.4 years; 64 males, 25 females) were diagnosed with JE (2.0%). Dysphagia was the most frequent symptom (80%), followed by chest pain (40%) and heartburn (25%). Esophagogastroduodenoscopy showed abnormal findings in 32% of patients: corkscrew/rosary beads appearance in 26%, narrowing in 11%. Eosinophilic infiltration (> 15 eosinophils/high power field) was diagnosed in 21%. Esophagography showed abnormal findings in 9% of the patients. For the initial therapy, 47 patients received medical treatment followed by peroral endoscopic myotomy (21 patients) and laparoscopic myotomy (two patients). Thirteen patients did not receive any treatment and 10 of those (77%) reported spontaneous resolution of symptoms. Patients who required invasive treatment experienced severe disability in their quality of life and greater maximal distal contractile integral than those who did not.CONCLUSIONS:HRM showed that the prevalence of JE was very low (2%). Esophagogastroduodenoscopy revealed some characteristic features of JE in patients. Some patients showed improvement of symptoms without invasive treatments. Follow-up with/without medical treatment should be considered before performing invasive treatment in patients whose distal contractile integral is relatively low and the quality of life is not impaired.
DOI	10.1007/s10388-022-00916-7
PMID	35249162