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conferenceseries
.com
Volume 7, Issue 7 (Suppl)
J Gastrointest Dig Syst
ISSN: 2161-069X JGDS, an open access journal
Gastroenterologists 2017
December 14-15, 2017
December 14-15, 2017 Dubai, UAE
11
th
World
Gastroenterologists Summit
What can a new endoscopic ling classification do for achalasia?
Yaqi Zhai and Enqiang Linghu
Chinese PLA General Hospital, China
P
eroral Endoscopic Myotomy (POEM) is a new minimally-invasive endoscopic method for achalasia, being expected to be
the first treatment choice with satisfactory short and moderate term outcome. We performed our first POEM in Oct 2010,
and gradually found not all the achalasia patients were eligible and equally safe to undergo POEM. Although achalasia had
been staged or classified on radiography or manometry, there was no endoscopic classification. We retrospectively analyzed
the endoscopic features of 976 achalasia patients in our endoscopic center and proposed a new endoscopic Ling classification.
According to presence of multi-ring, crescent-like structure and diverticulum, achalasia was divided into three subtypes: type
I, type II (a,b,c), type III. Then prospective study enrolling 341 patients with POEMwas performed to evaluate the clinical value
of the achalasia. Patients with different Ling subtypes suffered the similar degree of symptoms according to Eckardt scores.
Yet the Ling classification had significant correlation with symptom duration and lower esophageal sphincter pressure (LESP).
The patients with longer duration were more likely to developed Typer IIc and III and LESP of these Typer IIc and III patients
was obviously lower than the others. The overall success rate of POEM was 97.7% within 1-year follow-up and there was no
significant difference among different subtypes, whereas Ling classification had significant correlation with complications,
such as gas-related adverse and mucosal perforation. Ling IIc was showed to have the highest risk of complication and a
modified POEM with short tunnel was demonstrated effectively by us.
Biography
Yaqi Zhai is a Chief Doctor of Department of Gastroenterology and Hepatology of Chinese PLA General Hospital, completed his MD degree from Chinese PLA
Medical School. He was dedicated to digestive endoscopic tunnel technique and had published more than 10 papers in reputed journals. He was also a Member
of academic group of Capsule Endoscopy and Enteroscopy of CSGE.
astaring@163.comYaqi Zhai et al., J Gastrointest Dig Syst 2017, 7:7 (Suppl)
DOI: 10.4172/2161-069X-C1-061