Academic Journal
Management of Functional Esophagogastric Junction Outflow Obstruction ; A Systematic Review
| العنوان: | Management of Functional Esophagogastric Junction Outflow Obstruction ; A Systematic Review |
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| المؤلفون: | Garbarino, Stephanie, von Isenburg, Megan, Fisher, Deborah A., Leiman, David A. |
| المصدر: | Journal of Clinical Gastroenterology ; volume 54, issue 1, page 35-42 ; ISSN 0192-0790 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2020 |
| الوصف: | Goals: Awareness of functional esophagogastric junction outflow obstruction (fEGJOO) has increased, but because there is no consensus on its management, we performed a systematic review of the literature to explore treatment strategies and outcomes. Background: EGJOO is a heterogenous disorder defined by high-resolution manometry parameters of elevated integrated relaxation pressure with preserved esophageal peristalsis. The etiology may be mechanical obstruction or idiopathic, the latter being fEGJOO. Study: The PubMed/MEDLINE, Embase, and the Cochrane library electronic databases were searched through June 2018 for all studies of adult patients describing a treatment strategy for fEGJOO or incomplete lower esophageal sphincter relaxation. The search strategy yielded 1792 studies and 8 (0.4%) met inclusion criteria. Results: All but one included studies were retrospective (n=184 patients). There were 5 interventions described, with botulinum toxin (Botox) injection (n=69) and expectant management (n=82) the most frequently reported, with success rates of 58% and 54%, respectively. There was substantial heterogeneity among patients and treatments were not directly compared, though reported symptom resolution was similar among all strategies with a mean follow-up time of 15 months. Conclusions: There are a variety of management strategies available for fEGJOO and some patients may not require any intervention. However, among 4 potential approaches aimed at disrupting lower esophageal sphincter hypertonicity, the largest existing evidence base supports either a therapeutic challenge of Botox injection or watchful waiting. Ultimately, these data indicate the need for further study with controlled trials to identify a definitive approach. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1097/mcg.0000000000001156 |
| DOI: | 10.1097/MCG.0000000000001156 |
| الاتاحة: | http://dx.doi.org/10.1097/mcg.0000000000001156 https://journals.lww.com/10.1097/MCG.0000000000001156 |
| رقم الانضمام: | edsbas.F61AA4F4 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/mcg.0000000000001156 |
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