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Robotic Myotomy and Partial Fundoplication for Achalasia
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The 2018 ISDE achalasia guidelines.

G Zaninotto1, C Bennett2, G Boeckxstaens3

  • 1Department of Surgery and Cancer, Imperial College, London, UK.

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
|September 1, 2018
PubMed
Summary
This summary is machine-generated.

New guidelines offer a comprehensive framework for managing achalasia, a rare esophageal motility disorder. These Esophageal Achalasia Guidelines (I-GOAL) integrate expert consensus and evidence for diagnosis and treatment.

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Area of Science:

  • Gastroenterology
  • Esophageal Motility Disorders

Background:

  • Achalasia is a rare primary esophageal motor disorder causing dysphagia and regurgitation.
  • New diagnostic and therapeutic options necessitate updated management strategies.

Purpose of the Study:

  • To present the International Society for Diseases of the Esophagus Guidelines (I-GOAL) for achalasia management.
  • To provide clinicians and patients with an up-to-date framework for informed decision-making.

Main Methods:

  • Guidelines developed using the AGREE-REX tool and GRADE methodology.
  • Systematic literature search, expert consensus (DELPHI process with >80% approval).
  • Involved 51 international experts and 3 patient representatives.

Main Results:

  • Guidelines cover diagnosis, disease definition, severity, and various treatments (medical, botulinum toxin, pneumatic dilatation, POEM, myotomy).
  • Addresses recurrence, follow-up, cancer risk, end-stage disease, treatment failure, pediatric achalasia, and Chagas-related achalasia.
  • Recommendations based on integrated evidence grading and expert consensus.

Conclusions:

  • The I-GOAL guidelines provide a robust, evidence-based, and consensus-driven approach to achalasia management.
  • Aims to standardize care and improve outcomes for patients with this rare disorder.