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achalasia review

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https://www.readbyqxmd.com/read/28730503/chicago-classification-of-esophageal-motility-disorders-lessons-learned
#1
REVIEW
W O A Rohof, A J Bredenoord
PURPOSE OF REVIEW: High-resolution manometry (HRM) is increasingly performed worldwide, to study esophageal motility. The Chicago classification is subsequently applied to interpret the manometric findings and facilitate a diagnosis of esophageal motility disorders. This review will discuss new insights regarding the diagnosis and management using the Chicago classification. RECENT FINDINGS: Recent studies have demonstrated that high-resolution manometry is superior to conventional manometry, and has a higher sensitivity to diagnose achalasia...
August 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28726147/stent-migration-following-endoscopic-suture-fixation-of-esophageal-self-expandable-metal-stents-a-systematic-review-and-meta-analysis
#2
Ryan Law, Anoop Prabhu, Larissa Fujii-Lau, Carol Shannon, Siddharth Singh
BACKGROUND: Covered self-expandable metal stents (SEMS) are utilized for the management of benign and malignant esophageal conditions; however, covered SEMS are prone to migration. Endoscopic suture fixation may mitigate the migration risk of covered esophageal SEMS. Hence, we conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of endoscopic suture fixation for covered esophageal SEMS. METHODS: Following PRISMA guidelines, we performed a systematic review from 2011 to 2016 to identify studies (case control/case series) reporting the technical success and migration rate of covered esophageal SEMS following endoscopic suture fixation...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28724307/per-oral-endoscopic-myotomy-poem-a-new-endoscopic-treatment-for-achalasia
#3
Pablo Miranda García, Fernando Casals Seoane, Jean-Michel Gonzalez, Marc Barthet, Cecilio Santander Vaquero
BACKGROUND/AIMS: Per-oral endoscopic myotomy (POEM) is a new minimally invasive technique to treat achalasia. METHODS: We performed a review of the literature of POEM with a special focus on technical details and the results obtained with this technique in patients with achalasia and other esophageal motility disorders. RESULTS: Thousands of POEM procedures have been performed worldwide since its introduction in 2008. The procedure is based on the creation of a mucosal entry point in the proximal esophagus to reach the cardia through a submucosal tunnel and then perform a myotomy of the muscular layers of the cardia, esophagogastric junction and distal esophagus, as performed in a Heller myotomy...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28717439/achalasia-current-therapeutic-options
#4
REVIEW
Zubin Arora, Prashanthi N Thota, Madhusudhan R Sanaka
Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia...
June 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/28707343/peroral-endoscopic-myotomy-is-safe-and-effective-in-achalasia-patients-aged-older-than-60%C3%A2-years-compared-with-younger-patients
#5
Xiaowei Tang, Yutang Ren, Qiaoping Gao, Silin Huang, Jieqiong Zhou, Xiaofeng Zhang, Jianfeng Yang, Zhengjie Wei, Zhenyu Chen, Bo Jiang, Wei Gong
AIM: Peroral endoscopic myotomy (POEM) has been proven to be effective for treating achalasia, but there are limited data on POEM in elderly patients. We therefore aimed to assess the role of POEM for achalasia in patients aged ≥60 years. METHODS: All consecutive patients that underwent POEM between December 2011 and November 2015 at a single center were retrospectively reviewed. Patients aged ≥60 years were assigned to group A, whereas patients aged <60 years were assigned to group B...
July 14, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28665309/primary-esophageal-motility-disorders-beyond-achalasia
#6
REVIEW
Francisco Schlottmann, Marco G Patti
The best-defined primary esophageal motor disorder is achalasia. However, symptoms such as dysphagia, regurgitation and chest pain can be caused by other esophageal motility disorders. The Chicago classification introduced new manometric parameters and better defined esophageal motility disorders. Motility disorders beyond achalasia with the current classification are: esophagogastric junction outflow obstruction, major disorders of peristalsis (distal esophageal spasm, hypercontractile esophagus, absent contractility) and minor disorders of peristalsis (ineffective esophageal motility, fragmented peristalsis)...
June 30, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28658680/submucosal-fibrosis-in-achalasia-patients-is-a-rare-cause-of-aborted-peroral-endoscopic-myotomy-procedures
#7
Qiu-Ning Wu, Xiao-Yue Xu, Xiao-Cen Zhang, Mei-Dong Xu, Yi-Qun Zhang, Wei-Feng Chen, Ming-Yan Cai, Wen-Zheng Qin, Jian-Wei Hu, Li-Qing Yao, Quan-Lin Li, Ping-Hong Zhou
Background and aims Peroral endoscopic myotomy (POEM) is now an established treatment for esophageal achalasia. The standard protocol ensures a smooth operation in most patients, but technical challenges and failures exist and little is known about the incidence, causes, and impact of aborted procedures. Here, using a large patient cohort, we attempted to answer these questions. Methods All patients admitted for planned POEM between August 2010 and July 2015 underwent chart review. Aborted POEM was defined as the inability to finish the procedure after submucosal injection...
June 28, 2017: Endoscopy
https://www.readbyqxmd.com/read/28617027/efficacy-of-peroral-endoscopic-myotomy-compared-with-other-invasive-treatment-options-for-the-different-esophageal-motor-disorders
#8
Fermín Estremera-Arévalo, Eduardo Albéniz, María Rullán, Irene Areste, Rosa Iglesias, Juan José Vila
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been performed since 2008 on more than 5,000 patients. It has proven to be highly effective in the treatment of achalasia and has shown promising outcomes for other esophageal motility spastic disorders. METHODS: A literature review of the efficacy of POEM compared to the previous invasive treatments for different esophageal motility disorders was performed. The application in the pediatric and elderly populations and its role as a rescue therapy after other procedures are also outlined...
June 15, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28575249/esophageal-distensibility-measurement-impact-on-clinical-management-and-procedure-length
#9
N K Ahuja, A Agnihotri, K L Lynch, D Hoo-Fatt, F Onyimba, M McKnight, F C Okeke, P Garcia, S Dhalla, E Stein, P J Pasricha, J O Clarke
Luminal distensibility measurement has demonstrated relevance to various disease processes, though its effects on clinical decision-making have been less well understood. This study aims to characterize the clinical impact of impedance planimetry measurement as well as the learning curve associated with its use in the esophagus. A single provider performed distensibility measurement in conjunction with upper endoscopy for a variety of clinical indications with the functional lumen imaging probe (FLIP) over a period of 21 months...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28566891/ling-classification-describes-endoscopic-progressive-process-of-achalasia-and-successful-peroral-endoscopy-myotomy-prevents-endoscopic-progression-of-achalasia
#10
Wen-Gang Zhang, En-Qiang Linghu, Ning-Li Chai, Hui-Kai Li
AIM: To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy (POEM) to prevent endoscopic progression of achalasia. METHODS: We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients (197 women, 162 men) with a mean age of 42.1 years (range, 12-75 years) were evaluated...
May 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28549006/laparoscopic-heller-myotomy-versus-peroral-endoscopic-myotomy-poem-for-achalasia-a-systematic-review-and-meta-analysis
#11
Francisco Schlottmann, Daniel J Luckett, Jason Fine, Nicholas J Shaheen, Marco G Patti
OBJECTIVE: To compare the outcome of per oral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) for the treatment of esophageal achalasia. BACKGROUND: Over the last 2 decades, LHM has become the primary form of treatment in many centers. However, since the first description of POEM in 2010, this technique has widely disseminated, despite the absence of long-term results and randomized trials. METHODS: A systematic Medline literature search of articles on LHM and POEM for the treatment of achalasia was performed...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28536813/long-term-outcomes-of-heller-s-myotomy-and-balloon-dilatation-in-childhood-achalasia
#12
Efstratios Saliakellis, Nikhil Thapar, Derek Roebuck, Fernanda Cristofori, Kate Cross, Edward Kiely, Joseph Curry, Keith Lindley, Osvaldo Borrelli
Achalasia is a rare esophageal motility disorder: its optimal treatment in children is still a matter of debate. Records of children treated for achalasia, over an 18-year period, were reviewed.Forty-eight children (median age at diagnosis 10 years; range 3-17 years) were identified. Twenty-eight patients were initially treated with Heller's myotomy (HM) and 20 with balloon dilatation (BD). At last follow-up (median 3 years; range 1-5.5 years), 43.8% (21/48) of children were symptom free. The number of asymptomatic children was significantly higher among those treated initially with HM compared to BD (HM 15/28, 53...
May 23, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28529168/opioids-in-gastroenterology-treating-adverse-effects-and-creating-therapeutic-benefits
#13
Michael Camilleri, Anthony Lembo, David A Katzka
The use of opioid medications on both an acute and chronic basis is ubiquitous in the United States. As opioid receptors densely populate the gastrointestinal tract, symptoms and side effects can be expected in these patients. In the esophagus, dysmotility may result, manifesting with dysphagia and a syndrome indistinguishable from primary achalasia. In the stomach, a marked delay in gastric emptying may ensue with postprandial nausea and early satiety. Postoperatively, particularly with abdominal surgery, opioid-induced ileus may ensue...
May 19, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28485000/simultaneous-diagnosis-of-familial-achalasia-report-of-two-cases
#14
Masato Hoshino, Nobuo Omura, Fumiaki Yano, Se Ryung Yamamoto, Minoru Matsuda, Katsuhiko Yanaga
BACKGROUND: Achalasia is a rare disease with a morbidity of 1 in 100,000, for which the exact mechanism of pathogenesis has not been clarified due to the small total number of patients. We herein report on our experience with two cases of familial achalasia in which the involvement of genetic inheritance was suspected. CASE PRESENTATION: These cases consist of a man in his thirties and his mother in her sixties. The son consulted the Department of Gastrointestinal Medicine at our institute with dysphagia, and an upper gastrointestinal endoscopy revealed a gastric submucosal tumor with a maximal diameter of approximately 50 mm...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28475741/clinical-presentation-and-disease-course-of-patients-with-esophagogastric-junction-outflow-obstruction
#15
K L Lynch, Y-X Yang, D C Metz, G W Falk
Esophagogastric junction outflow obstruction, characterized by preserved peristalsis in conjunction with an elevated integrated relaxation pressure, can result from specific anatomic variants or may represent achalasia in evolution. There is limited information on the clinical significance of this diagnosis. The aim of this study is to describe the clinical characteristics and outcomes in our cohort of patients with esophagogastric junction outflow obstruction.Consecutive adult patients who had undergone high-resolution esophageal manometry between February 2013 and November 2015 with a diagnosis of esophagogastric junction outflow obstruction were identified...
June 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28472017/systematic-review-and-meta-analysis-of-perioperative-outcomes-of-peroral-endoscopic-myotomy-poem-and-laparoscopic-heller-myotomy-lhm-for-achalasia
#16
Aiman Awaiz, Rossita M Yunus, Shahjahan Khan, Breda Memon, Muhammed A Memon
AIMS AND OBJECTIVES: Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM. MATERIALS AND METHODS: A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, and current contents for English-language articles comparing LHM and POEM between 2007 and 2016 was performed...
June 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28429200/achalasia-it-is-not-all-black-and-white
#17
REVIEW
Santosh Sanagapalli, Rami Sweis
PURPOSE OF REVIEW: This review aims to shed light on subtleties of achalasia diagnosis, including potential pitfalls that may lead to errors. Optimal methods for assessment of disease severity and the relationship between achalasia and other motility disorders will also be reviewed with an emphasis on recent findings from the literature. RECENT FINDINGS: Adjunctive testing with viscous substances or larger water volumes should be used routinely as it improves the accuracy of achalasia diagnosis...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28426463/treatments-for-achalasia-in-2017-how-to-choose-among-them
#18
Peter J Kahrilas, John E Pandolfino
PURPOSE OF REVIEW: To review recent advances in achalasia diagnostics and therapeutics. RECENT FINDINGS: The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]...
July 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28375450/patient-reported-outcome-measures-in-dysphagia-a-systematic-review-of-instrument-development-and-validation
#19
D A Patel, R Sharda, K L Hovis, E E Nichols, N Sathe, D F Penson, I D Feurer, M L McPheeters, M F Vaezi, David O Francis
OBJECTIVE: Patient-reported outcome (PRO) measures are commonly used to capture patient experience with dysphagia and to evaluate treatment effectiveness. Inappropriate application can lead to distorted results in clinical studies. A systematic review of the literature on dysphagia-related PRO measures was performed to (1) identify all currently available measures and (2) to evaluate each for the presence of important measurement properties that would affect their applicability. DESIGN: MEDLINE via the PubMed interface, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument database were searched using relevant vocabulary terms and key terms related to PRO measures and dysphagia...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28361839/peroral-endoscopic-myotomy-achieves-similar-clinical-response-but-incurs-lesser-charges-compared-to-robotic-heller-myotomy
#20
COMPARATIVE STUDY
Mouen A Khashab, Vivek Kumbhari, Alan H Tieu, Mohamad H El Zein, Amr Ismail, Saowanee Ngamruengphong, Vikesh K Singh, Anthony N Kalloo, John O Clarke, Ellen M Stein
BACKGROUND/AIM: Several uncontrolled studies comparing peroral endoscopic myotomy (POEM) and Heller myotomy have demonstrated equivalent short-term efficacy and safety. However, no data exists rergarding the cost of POEM and how it compares to that of robotic Heller myotomy (RHM). The primary aim of this study was to compare the inpatient charges incurred in patients who underwent POEM or RHM for the treatment of achalasia. PATIENTS AND METHODS: A retrospective single center review was conducted among 52 consecutive POEM patients (2012-2014) and 52 consecutive RHM patients (2009-2014)...
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
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