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• W33599256 abstract "Objectif: Repondre a un certain nombre d’interrogations, classees en: Materiel et methode: Etude retrospective de 388 cas de suspicion d’achalasie, sur 1434 examens manometriques realises au service, sur une periode de 10 ans allant de janvier 1990 a decembre 2000. Seuls 184 cas ont ete retenus selon nos criteres d’inclusion. Le materiel et la technique de manometrie œsophagienne utilises ont ete conformes aux regles methodologiques preconisees par l’Agence Nationale d’Accreditation et d’Evaluation en Sante (ANAES). L’analyse statistique a ete faite a l’aide d’un logiciel SPSS. Resultats: La prevalence de l’achalasie dans notre serie etait de 12,8 %. La dysphagie etait le maitre symptome retrouve dans 97,3 % des cas. Le delai moyen entre l’apparition des signes cliniques et le diagnostic manometrique etait de 38,2 ±4 mois. Le diagnostic de l’achalasie a ete porte a un stade precoce d’achalasie vigoureuse ou hyperkinetique chez 40,2 % des patients, et a un stade d’achalasie hypokinetique dans 59,8 % des cas. La manometrie a mis en evidence les signes majeurs de l’achalasie: une relaxation du SIO en reponse a la deglutition absente ou incomplete dans 96,7 % des cas, un aperistaltisme œsophagien dans 95,6 % des cas, et l’hypertonie du SIO, signe mineur, a ete objectivee chez 80,4 % des patients. La pression sphincterienne etait encore normale chez 60 % des patients dans le groupe d’achalasie vigoureuse ou hyperkinetique (p = 0,02). Nous n’avons pas mis en evidence de particularites manometriques liees a l’âge, au sexe; de meme, nous n’avons pas note de difference significative entre la frequence des signes cliniques, et les donnees manometriques: la pression du SIO, la relaxation et l’aperistaltisme. Conclusion: La manometrie œsophagienne est incontournable pour le diagnostic precoce d’achalasie, alors que les autres examens sont encore normaux. La precocite du diagnostic permet d’ameliorer les resultats fonctionnels post-therapeutiques. La realisation de la manometrie pre-operatoire oriente l’acte therapeutique. Aims of study:To answer to a certain number of questions: Material and method: Retrospective study of 388 cases with achalasia suspicion, on 1,434 manometry examination performed in the Functional digestive explorations department, at University hospital “Ibn Sina” of Rabat in Morocco, on a period of 10 years between January 1990 to December 2000. Only 184 cases have been kept in the clinical study, according to our inclusion criteria. Material and technique of esophageal manometry used were compliant to the methodological rules recommended by the French National Agency of Health Accreditation and Evaluation (ANAES). The statistical analysis has been made with the help of a software SPSS. Results:Prevalence of the achalasia in our study was 12,8 %. Dysphagia was the main symptom found in 97,3 % of cases. The mean delay between apparition of clinical signs and manometrie diagnosis was 38,2 ± 4 months. The diagnosis of achalasia was made at an early stage of vigorous or hyper kinetic achalasia in 40,2 % of patients, and at a stage of hypokinetic achalasia in 59,8 % of cases. Manometry diagnoses the major signs of the achalasia: relaxation of the LES in response to an absent or incomplete swallowing in 96,7 % of cases, esophageal aperistalsis in 95,6 % of cases, and hypertonic LES as a minor sign, was found in 80,4 % of patients. Sphincterian pressure was even normal in 60 % of patients in the group of vigorous or hyperkinetic achalasia (P = 0,02). We did not note any manometric particularities bound to age or gender, neither did we note any significant difference between the frequency of clinical signs, and manometric data: the pressure of the LES, relaxation and the absence of peristalsis. Conclusion:Esophageal manometry is indispensable for early diagnosis of achalasia, even if the other exams are normal. The forwardness of the diagnosis allows to improve the posttherapeutic functional results. The realization of the preoperative manometry orients the therapeutic act." @default.
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• W33599256 date "2003-10-01" @default.
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• W33599256 title "La manométrie œsophagienne est-elle incontournable dans la prise en charge de l’achalasie ?" @default.
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