胃と腸59巻9号

2024年09月発行

今月の主題 食道運動障害の診断と治療

主題

High-resolution manometryとシカゴ分類

著者： 秋山純一¹ 竜野稜子¹ 赤澤直樹¹ 横井千寿¹

所属機関： ¹国立国際医療研究センター病院消化器内科

ページ範囲：P.1195 - P.1204

文献概要

要旨●シカゴ分類は，HRMの所見を用いて食道運動障害を分類するスキームである．シカゴ分類第4版（CC v4.0）における主な変更点としては，標準化されたHRMプロトコル（臥位，座位，負荷テストなど）が考案されたこと，EGJOOの診断基準が改定されたこと，IEMの診断基準が厳格化したことなどである．これにより，食道蠕動運動障害やEGJ通過障害のパターンについての，より標準的で厳密な判定基準が提示された．

参考文献

. Neurogastroenterol Motil　33：e14058, 2021

2）Kahrilas PJ, Bredenoord AJ, Fox M, et al. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil　27：160-174, 2015

3）Bredenoord AJ, Fox M, Kahrilas PJ, et al. Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography. Neurogastroenterol Motil　24（Suppl 1）：57-65, 2012

4）Pandolfino JE, Fox MR, Bredenoord AJ, et al. High-resolution manometry in clinical practice：utilizing pressure topography to classify oesophageal motility abnormalities. Neurogastroenterol Motil　21：796-806, 2009

5）Alcala Gonzalez LG, Oude Nijhuis RAB, Smout A, et al. Normative reference values for esophageal high-resolution manometry in healthy adults：a systematic review. Neurogastroenterol Motil　33：e13954, 2021

6）Bredenoord AJ, Babaei A, Carlson D, et al. Esophagogastric junction outflow obstruction. Neurogastroenterol Motil　33：e14193, 2021

7）Chen JW, Savarino E, Smout A, et al. Chicago classification update（v4.0）：technical review on diagnostic criteria for hypercontractile esophagus. Neurogastroenterol Motil　33：e14115, 2021

technical review：update on standard high-resolution manometry protocol for the assessment of esophageal motility. Neurogastroenterol Motil　33：e14120, 2021

9）Gyawali CP, Zerbib F, Bhatia S, et al. Chicago Classification update（V4.0）：technical review on diagnostic criteria for ineffective esophageal motility and absent contractility. Neurogastroenterol Motil　33：e14134, 2021

10）Kahrilas PJ, Mittal RK, Bor S, et al. Chicago Classification update（v4.0）：technical review of high-resolution manometry metrics for EGJ barrier function. Neurogastroenterol Motil　33：e14113, 2021

11）Khan A, Yadlapati R, Gonlachanvit S, et al. Chicago classification update（version 4.0）：technical review on diagnostic criteria for achalasia. Neurogastroenterol Motil　33：e14182, 2021

12）Roman S, Hebbard G, Jung KW, et al. Chicago classification update（v4.0）：technical review on diagnostic criteria for distal esophageal spasm. Neurogastroenterol Motil　33：e14119, 2021

13）Hoshikawa Y, Momma E, Kawami N, et al. High-resolution manometry with additional maneuvers using the Starlet system：normative thresholds and diagnostic yields for relevant esophagogastric junction outflow disorders. Esophagus　20：150-157, 2023

14）Kuribayashi S, Iwakiri K, Shinozaki T, et al. Clinical impact of different cut-off values in high-resolution manometry systems on diagnosing esophageal motility disorders. J Gastroenterol　54：1078-1082, 2019

15）Kuribayashi S, Iwakiri K, Kawada A, et al. Variant parameter values-as defined by the Chicago criteria-produced by ManoScan and a new system with unisensor catheter. Neurogastroenterol Motil　27：188-194, 2015

16）Pandolfino JE, Kim H, Ghosh SK, et al. High-resolution manometry of the EGJ：an analysis of crural diaphragm function in GERD. Am J Gastroenterol　102：1056-1063, 2007

17）Akimoto S, Singhal S, Masuda T, et al. Classification for esophagogastric junction（EGJ）complex based on physiology. Dis Esophagus　30：1-6, 2017

18）Yadlapati R, Pandolfino JE, Fox MR, et al. What is new in Chicago classification version 4.0? Neurogastroenterol Motil　33：e14053, 2021

19）日本消化管学会（編）．食道運動障害診療指針．南光堂，2016