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2014 ; 2
(3
): E178-82
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In vivo histopathological assessment of the muscularis propria in achalasia by
using endocytoscopy (with video)
#MMPMID26134965
Sato H
; Inoue H
; Ikeda H
; Sato C
; Santi EG
; Phalanusitthepha C
; Aoyagi Y
; Kudo SE
Endosc Int Open
2014[Sep]; 2
(3
): E178-82
PMID26134965
show ga
BACKGROUND: The histopathology of the muscularis propria (MP) is unknown in
patients with achalasia. Endocytoscopy (EC) was developed as an ultra-high
magnification endoscopy, and the submucosal tunnel created during peroral
endoscopic myotomy (POEM) not only provides access to the MP but also enables
subsequent endoscopic assessment of the MP. PATIENTS AND METHODS: In seven
patients with achalasia (mean?±?SD; 35?±?18.1 years; men:women, 4:3) who
underwent POEM (myotomy length: 12?±?2.2?cm), subsequent EC examination was
performed from the mid-esophagus to the gastric side. EC images were compared to
the results of histopathologic examination (two biopsies from the mid-esophagus
and lower esophageal sphincter), which was the standard. RESULTS: In all
patients, favorable EC images were obtained, and spindle-shaped smooth muscle
cells were detected. In our series, we observed no notable features such as
atrophy or hypertrophy of smooth muscle cells. In addition, the EC assessment was
consistent with the results of biopsy. No complications were encountered during
any of the procedures. CONCLUSION: In a clinical setting, real-time assessment of
the MP using EC is feasible. This technique may play an important role in
determining the pathology of achalasia and other diseases that affect
gastrointestinal function.