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achalasia review

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https://www.readbyqxmd.com/read/28050913/technological-review-on-endoscopic-submucosal-dissection-available-equipment-recent-developments-and-emerging-techniques
#1
Georgios Mavrogenis, Juergen Hochberger, Pierre Deprez, Morteza Shafazand, Dimitri Coumaros, Katsumi Yamamoto
Endoscopic submucosal dissection (ESD) is widely practiced in Japan and the Eastern World and is rapidly expanding in western countries for the management of early malignancies of the upper and lower gastrointestinal tube. In addition, novel therapeutic applications deriving from ESD have emerged including the treatment of achalasia, of submucosal tumors, of diverticula, of strictures and of reflux disease. An ESD procedure necessitates not only skills and specific training, but also familiarization with a vast spectrum of devices (endoscopes, high-frequency generators and their settings, endoknives, hoods, irrigation devices) and techniques (such as countertraction, artificial ulcer closure), that render the procedure faster, more efficient and safer...
January 4, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28011013/health-related-quality-of-life-after-laparoscopic-heller-myotomy-and-dor-fundoplication-for-achalasia
#2
Emanuele Asti, Andrea Sironi, Andrea Lovece, Giulia Bonavina, Melania Fanelli, Gianluca Bonitta, Luigi Bonavina
BACKGROUND: In addition to symptom scores, a person's perception of health and quality of life assessment is an important indicator of quality of treatment and can provide an efficient index to compare different therapeutic modalities in chronic disease states. Only a few studies have investigated quality of life comprehensively in patients with achalasia, and therefore the controversy regarding the best treatment algorithm continues. The primary study outcome was pre- and postoperative quality of life in patients with achalasia undergoing laparoscopic Heller myotomy and Dor fundoplication...
December 20, 2016: Surgery
https://www.readbyqxmd.com/read/28009686/etiology-and-pathogenesis-of-idiopathic-achalasia
#3
Amanda Pressman, Jose Behar
This review examines the etiology and pathogenesis of idiopathic achalasia. This disease is clinically characterized by dysphagia of solids and liquids due to the presence of simultaneous or absent esophageal contractions and impaired or absent relaxation of the lower esophageal sphincter. It includes a review of (a) etiology and pathogenesis of this inflammatory process that damage the ganglion cells of the Auerbach plexus that is limited to the esophagus; (b) genetic abnormalities and polymorphisms associated with this disease that may help explain its heterogeneity expressed by the different motility abnormalities of its phenotypes as well as differences in its clinical progression...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27973949/robot-assisted-heller-s-myotomy-for-achalasia-in-children
#4
Tariq Altokhais, Hala Mandora, Ayed Al-Qahtani, Abdulrahman Al-Bassam
BACKGROUND: Achalasia is rare in children. Surgical options include open, laparoscopic and robotic approaches. However, Heller's myotomy remains the treatment of choice. This report describes our experience with robot-assisted Heller's myotomy in children and presents a review of the literature. METHODS: Included in this study are children who underwent robot-assisted Heller's myotomy for esophageal achalasia via the Da Vinci surgical system between 2004 and 2015 at King Saud University Medical City, Riyadh, Saudi Arabia...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27912977/functional-outcomes-in-hirschsprung-disease-a-single-institution-s-12-year-experience
#5
Hemanshoo S Thakkar, Christopher Bassett, Andy Hsu, Riccardo Manuele, Dorothy Kufeji, Catherine A Richards, Meena Agrawal, Alireza S Keshtgar
AIMS: Hirschsprung disease (HD) is a chronic condition associated with long-term morbidity. We assessed the short and long-term functional outcomes of operated patients in a single institution over a 12-year period. MATERIALS AND METHODS: We conducted a retrospective review of all children operated for HD between 2002 and 2014. Postoperative functional outcomes were assessed using the Rintala Bowel Function Score (BFS, 0-20, 20=best score). We assessed hospital admissions, complications including Hirschsprung associated enterocolitis (HAEC) and the need for further surgical procedures...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27901639/results-of-laparoscopic-heller-s-myotomy-for-achalasia-in-children-a-systematic-review-of-the-literature
#6
Maurizio Pacilli, Mark Davenport
INTRODUCTION: Achalasia is a rare disorder in children who are commonly treated by laparoscopic Heller's myotomy (LHM). However, there are no large studies evaluating the results of LHM in the pediatric population, and the need of a concomitant fundoplication remains unclear. The aim of the study is to appraise the results of LHM based on a systematic literature review. MATERIALS AND METHODS: MEDLINE search of the English literature was performed for "achalasia," "children," "laparoscopy," "Heller," "myotomy," and "cardiomyotomy...
January 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27886865/two-cases-of-pseudo-achalasia-with-lung-cancer-case-report-and-short-literature-review
#7
Taizou Hirano, Eisaku Miyauchi, Akira Inoue, Ryotaro Igusa, Shigeki Chiba, Kazuhiro Sakamoto, Hisatoshi Sugiura, Toshiaki Kikuchi, Masakazu Ichinose
Pseudo-achalasia with lung cancer is a rare complication. We present 2 cases of pseudo-achalasia with lung cancer and summarize previous reports. The previous reports suggested that lung cancer can be complicated with pseudo-achalasia caused by paraneoplastic neurological syndromes rather than direct invasion of the tumor cells to the lower esophageal sphincter, irrespective of the histology of the lung cancer; this can strongly influence the performance status. Treatment for pseudo-achalasia improves not only the symptoms, but also the performance status...
November 2016: Respiratory Investigation
https://www.readbyqxmd.com/read/27865290/pneumatic-dilation-of-the-lower-esophageal-sphincter-can-now-be-successfully-performed-without-morbidity
#8
Yi Jia, Marco Bustamante, Sharareh Moraveji, Richard W McCallum
BACKGROUND: Patients with dysphagia may be diagnosed with impaired lower esophageal sphincter (LES) relaxation and treated with pneumatic dilation (PD), stretching and tearing LES muscle fibers. Esophageal perforation has been reported to be as high as 10%. We conducted a retrospective study to evaluate the perforation rate of PD when used for impaired relaxation of the LES using current techniques. METHODS: A chart review was conducted to identify patients referred for esophageal manometry by high-resolution manometry and later received PD from January 2013 to April 2016...
November 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27858325/is-poem-the-answer-for-management-of-spastic-esophageal-disorders-a-systematic-review-and-meta-analysis
#9
REVIEW
Muhammad Ali Khan, Vivek Kumbhari, Saowanee Ngamruengphong, Amr Ismail, Yen-I Chen, Yamile Haito Chavez, Majidah Bukhari, Richard Nollan, Mohammad Kashif Ismail, Manabu Onimaru, Valerio Balassone, Ahmed Sharata, Lee Swanstrom, Haruhiro Inoue, Alessandro Repici, Mouen A Khashab
BACKGROUND AND AIMS: Spastic esophageal disorders (SEDs) include spastic achalasia (type III), diffuse esophageal spasm (DES), and nutcracker/jackhammer esophagus (JH). Per-oral endoscopic myotomy (POEM) has demonstrated efficacy and safety in the treatment of achalasia. Recently, POEM has been indicated for the treatment of SEDs. We conducted a systematic review and meta-analysis to determine the clinical success and safety of POEM in SEDs. METHODS: We searched several databases from 01/01/2007 to 01/10/2016 to identify studies (with five or more patients) on POEM for the treatment of SEDs...
January 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27858209/outcomes-in-patients-with-over-1-year-follow-up-after-peroral-endoscopic-myotomy-poem
#10
Marc A Ward, Matt Gitelis, Lava Patel, Yalini Vigneswaran, Joann Carbray, Michael B Ujiki
BACKGROUND: Peroral endoscopic myotomy (POEM) is a promising therapy in the treatment of achalasia. The study was designed to report outcomes, including quality of life, in patients with at least 1-year follow-up. METHODS: Patients from an institutional review board-approved protocol underwent POEM and were followed prospectively. Health-related quality of life was measured preoperatively and 1 year post-operatively using Short Form-36 Health Survey version 2 (SF-36v2)...
November 17, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27855465/from-poem-to-poet-applications-and-perspectives-for-submucosal-tunnel-endoscopy
#11
Philip W Y Chiu, Haruhiro Inoue, Thomas Rösch
Recent advances in submucosal endoscopy have unlocked a new horizon for potential development in diagnostic and therapeutic endoscopy. Increasing evidence has demonstrated that peroral endoscopic myotomy (POEM) is not only clinically feasible and safe, but also has excellent results in symptomatic relief of achalasia. The success of submucosal endoscopy in performance of tumor resection has confirmed the potential of this new area in diagnostic and therapeutic endoscopy. This article reviews the current applications and evidence, from POEM to peroral endoscopic tunnel resection (POET), while exploring the possible future clinical applications in this field...
December 2016: Endoscopy
https://www.readbyqxmd.com/read/27836361/ultrasound-guided-intrasphincteric-botulinum-toxin-injection-relieves-obstructive-defecation-due-to-hirschsprung-s-disease-and-internal-anal-sphincter-achalasia
#12
Joseph T Church, Samir K Gadepalli, Toghrul Talishinsky, Daniel H Teitelbaum, Marcus D Jarboe
PURPOSE: Chronic obstructive defecation can occur in patients with Hirschsprung Disease (HD) and internal anal sphincter (IAS) achalasia. Injection of Botulinum Toxin (BoTox) into the IAS can temporarily relieve obstructive defecation, but can be challenging when performed by tactile sense alone. We compared results of BoTox injections with and without ultrasound (US) guidance. METHODS: We retrospectively reviewed BoTox injections into the IAS for obstructive defecation over 5years...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27809769/retrospective-analysis-of-management-of-ingested-foreign-bodies-and-food-impactions-in-emergency-endoscopic-setting-in-adults
#13
Girolamo Geraci, Carmelo Sciume', Giovanni Di Carlo, Antonino Picciurro, Giuseppe Modica
BACKGROUND: Ingestion of foreign bodies and food impaction represent the second most common endoscopic emergency after bleeding. The aim of this paper is to report the management and the outcomes in 67 patients admitted for suspected ingestion of foreign body between December 2012 and December 2014. METHODS: This retrospective study was conducted at Palermo University Hospitals, Italy, over a 2-year period. We reviewed patients' database (age, sex, type of foreign body and its anatomical location, treatments, and outcomes as complications, success rates, and mortalities)...
November 4, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27771944/is-gastroesophageal-reflux-disease-and-achalasia-coincident-or-not
#14
REVIEW
Da Hyun Jung, Hyojin Park
Achalasia and gastroesophageal reflux disease (GERD) are on opposite ends of the spectrum of lower esophageal sphincter dysfunction. Heartburn is the main symptom of GERD. However, heartburn and regurgitation are frequently observed in patients who have achalasia. The diagnosis of achalasia might be delayed because these symptoms are misinterpreted as gastroesophageal reflux. Here, we reviewed the clinical characteristics of patients with the erroneous diagnosis of GERD who actually had untreated achalasia.
January 30, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/27754816/achalasia-2016-treatment-alternatives
#15
Fernando A M Herbella, Eduardo G H Moura, Marco G Patti
The treatment for achalasia changed dramatically after the introduction of minimally invasive surgery. Since 1991, laparoscopic Heller myotomy (LHM) has replaced pneumatic dilatation (PD) as the primary form of treatment in many centers. Over time, PD became safer, and eventually endoscopic experts were able to perform an endoscopic myotomy via a per oral endoscopic myotomy (POEM). This article reviews the advantages and disadvantages of each technique. Ultimately, the best outcomes are obtained by a multidisciplinary team that can tailor a specific treatment to each individual patient...
January 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27698338/alacrima-as-a-harbinger-of-adrenal-insufficiency-in-a-child-with-allgrove-aaa-syndrome
#16
Brande Brown, Levon Agdere, Cornelia Muntean, Karen David
BACKGROUND Allgrove syndrome, or triple "A" syndrome (3A syndrome), is a rare autosomal recessive syndrome with variable phenotype, and an estimated prevalence of 1 per 1,000,000 individuals. Patients usually display the triad of achalasia, alacrima, and adrenocorticotropin (ACTH) insensitive adrenal insufficiency, though the presentation is inconsistent. CASE REPORT Here, the authors report a case of Allgrove syndrome in a pediatric patient with delayed diagnosis in order to raise awareness of this potentially fatal disease as a differential diagnosis of alacrima...
October 4, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27692913/robotic-heller-myotomy-for-achalasia-after-laparoscopic-roux-en-y-gastric-bypass-a-case-report-and-literature-review
#17
Mario Masrur, Luis Fernando Gonzalez-Ciccarelli, Pier C Giulianotti
No abstract text is available yet for this article.
November 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27672286/new-insights-into-the-pathophysiology-of-achalasia-and-implications-for-future-treatment
#18
REVIEW
Janette Furuzawa-Carballeda, Samuel Torres-Landa, Miguel Ángel Valdovinos, Enrique Coss-Adame, Luis A Martín Del Campo, Gonzalo Torres-Villalobos
Idiopathic achalasia is an archetype esophageal motor disorder, causing significant impairment of eating ability and reducing quality of life. The pathophysiological underpinnings of this condition are loss of esophageal peristalsis and insufficient relaxation of the lower esophageal sphincter (LES). The clinical manifestations include dysphagia for both solids and liquids, regurgitation of esophageal contents, retrosternal chest pain, cough, aspiration, weight loss and heartburn. Even though idiopathic achalasia was first described more than 300 years ago, researchers are only now beginning to unravel its complex etiology and molecular pathology...
September 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27663714/long-term-outcomes-of-per-oral-endoscopic-myotomy-in-patients-with-achalasia-with-a-minimum-follow-up-of-2-years-an%C3%A2-international-multicenter-study
#19
Saowanee Ngamruengphong, Haruhiro Inoue, Philip Wai-Yan Chiu, Hon Chi Yip, Amol Bapaye, Michael Ujiki, Lava Patel, Pankaj N Desai, Bu Hayee, Amyn Haji, Vivien Wai-Yin Wong, Silvana Perretta, Shivangi Dorwat, Mathieu Pioche, Sabine Roman, Jérôme Rivory, François Mion, Thierry Ponchon, Aurélien Garros, Jun Nakamura, Yoshitaka Hata, Valerio Balassone, Manabu Onimaru, Gulara Hajiyeva, Amr Ismail, Yen-I Chen, Majidah Bukhari, Yamile Haito-Chavez, Vivek Kumbhari, Roberta Maselli, Alessandro Repici, Mouen A Khashab
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) has shown promising safety and efficacy in short-term studies. However, long-term follow-up data are very limited. The aims of this study were to assess (1) clinical outcome of patients with a minimum post-POEM follow-up of 2 years and (2) factors associated with long-term clinical failure after POEM. METHODS: A retrospective chart review was performed that included all consecutive patients with achalasia who underwent POEM with a minimum follow-up of 2 years at 10 tertiary-care centers...
September 20, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27649684/peroral-endoscopic-myotomy-versus-pneumatic-dilation-for-achalasia-in-patients-aged-%C3%A2-65-years
#20
Xuehong Wang, Yuyong Tan, Liang Lv, Hongyi Zhu, Yi Chu, Chenjie Li, Deliang Liu
BACKGROUND AND AIM: Both peroral endoscopic myotomy (POEM) and pneumatic dilation (PD) has proved to be effective for treating achalasia in patients aged ≥ 65 years. However little is known about the comparison between POEM and PD. The aim of the study was to compare the safety and efficacy of POEM and PD for the treatment of achalasia in these patients. METHODS: We retrospectively reviewed the medical records of patients aged 65 years-old or more who received POEM or PD for the treatment of achalasia at our hospital from January 2010 to December 2015, they were divided into the POEM group and the PD group...
October 2016: Revista Española de Enfermedades Digestivas
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