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dysphagia and fundoplications

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https://www.readbyqxmd.com/read/29768079/the-spectrum-of-surgical-remediation-of-transoral-incisionless-fundoplication-related-failures
#1
Ruchir Puri, C Daniel Smith, Steven P Bowers
AIM: To evaluate outcomes of surgical remediation for symptomatic or anatomic failure after a transoral incisionless fundoplication (TIF). METHODS: This retrospective study was performed on 11 patients who underwent a remedial operation following TIF failure between June 2011 and September 2016 at the Mayo Clinic in Florida for persistent foregut symptoms. Upper gastrointestinal workup characterized 1 patient as having normal post-TIF anatomy and 10 as having anatomic failure...
May 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29712594/poem-for-achalasia
#2
Daniel A Kroch, Ian S Grimm
In 2008, a new treatment modality for esophageal achalasia was introduced-peroral endoscopic myotomy (POEM). POEM is a procedure performed endoscopically, which allows transection of the muscular fibers of the distal esophagus and of the lower esophageal sphincter. The procedure is therefore similar to a laparoscopic Heller myotomy without a fundoplication. Short-term studies have shown that POEM is very effective in relieving dysphagia and regurgitation, but concerns have been raised about the incidence of post-POEM gastroesophageal reflux...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712592/laparoscopic-heller-myotomy-for-achalasia-technical-aspects
#3
Francisco Schlottmann, Marco E Allaix, Marco G Patti
Esophageal achalasia is a primary esophageal motility disorder defined by the lack of esophageal peristalsis, and by a lower esophageal sphincter that fails to relax in response to swallowing. Patients' symptoms include dysphagia, regurgitation, aspiration, heartburn, and chest pain. Achalasia is a chronic condition without cure, and treatment options are aimed at providing symptomatic relief, improving esophageal emptying, and preventing the development of megaesophagus. Presently, a laparoscopic Heller myotomy with a partial fundoplication is considered the best treatment modality...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29668668/tailored-fundoplication-with-endoluminal-functional-lumen-imaging-probe-allows-for-successful-minimally-invasive-hiatal-hernia-repair
#4
Min P Kim, Leonora M Meisenbach, Edward Y Chan
Endoluminal functional lumen imaging probe (EndoFLIP) can provide real time information about characteristics of the gastroesophageal junction. We performed retrospective analysis of prospectively collected data on use of EndoFLIP during minimally invasive hiatal hernia repair to tailor the size of the crural closure and size of the fundoplication. We then determined whether it provides good reflux control without significant dysphagia. Forty patients underwent minimally invasive hiatal hernia repair with fundoplication...
April 17, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29657705/laparoscopic-transhiatal-resection-of-a-large-mid-esophageal-diverticulum-a-case-report
#5
Tomislav Tokic, Iva Kirac, Davor Hrabar, Branko Troskot, Miroslav Bekavac-Beslin
This is a description of transhiatal laparoscopic approach for mid-esophageal diverticulum. Traditionally mid-esophageal diverticula are approached by thoracotomy or thoracoscopy, with the laparoscopic technique being reserved for epiphrenic diverticula. A 78-year-old Caucasian female with a secondary dilatative ischemic cardiomyopathy presented with dysphagia, tenderness in the epigastrium and a considerable weight loss. A large mid-esophageal diverticulum was found on barium swallow and confirmed by CT scan...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29656451/patient-with-mediastinitis-caused-by-delayed-mucosal-damage-after-peroral-endoscopic-myotomy
#6
Hiroki Okada, Hironari Shiwaku, Kanefumi Yamashita, Toshihiro Ohmiya, Haruhiro Inoue, Suguru Hasegawa
Peroral endoscopic myotomy (POEM) is a groundbreaking procedure for treating esophageal achalasia, and many reports from various facilities have described its safety and efficacy. However, there have been few reports on adverse events. Here, we report a case of a patient with mediastinitis caused by delayed mucosal damage after POEM. This case was the most severe among all POEM cases at our hospital. A 58-year-old man had experienced dysphagia and chest tightness since he was around 50 years old. At a previous hospital, he had been diagnosed with nonerosive reflux disease and had undergone fundoplication...
April 15, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29619511/results-of-magnetic-sphincter-augmentation-for-gastroesophageal-reflux-disease
#7
Katrin Schwameis, Milena Nikolic, Deivis G Morales Castellano, Ariane Steindl, Sarah Macheck, Ivan Kristo, Barbara Zörner, Sebastian F Schoppmann
BACKGROUND: Magnetic sphincter augmentation (MSA) is a modern treatment option for gastroesophageal reflux disease (GERD); however, laparoscopic fundoplication remains the gold standard. The aim of the study was to evaluate outcomes of MSA patients at a reflux center. METHODS: A retrospective review was performed of all patients that underwent MSA between March 2012 and November 2017. Out of 110 patients, 68 with a follow-up >3 months were included. Postoperative gastrointestinal symptoms, proton pump inhibitor (PPI) intake, GERD-Health-related Quality of Life (GERD-HRQL) and alimentary satisfaction (AS) were assessed...
April 4, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29603510/esophageal-provocation-tests-are-they-useful-to-improve-diagnostic-yield-of-high-resolution-manometry
#8
REVIEW
D A Carlson, S Roman
High resolution manometry (HRM) is the gold standard to diagnose esophageal motility disorders but has some limitations. The inclusion of provocative tests might enhance the diagnostic yield of HRM. These tests are easy to perform and to add to the regular manometry protocol. Multiple rapid swallows (MRS; 5 2-mL swallows) is useful to assess the contractile reserve and deglutitive inhibition. The optimal number of MRS to perform might be 3 as suggested by Mauro et al. in this issue of Neurogastroenterology & Motility...
April 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29580341/laparoscopic-heller-myotomy-with-anterior-fundoplication-improves-frequency-and-severity-of-symptoms-of-achalasia-regardless-of-preoperative-severity-determined-by-esophagography
#9
Alexander Rosemurgy, Darrell Downs, Kenneth Luberice, Christian Rodriguez, Forat Swaid, Krishen Patel, Paul Toomey, Sharona Ross
This study was undertaken to determine whether postoperative outcomes after laparoscopic Heller myotomy with anterior fundoplication could be predicted by preoperative findings on esophagography. Preoperative barium esophagograms of 135 patients undergoing laparoscopic Heller myotomy with anterior fundoplication were reviewed. The number of esophageal curves, esophageal width, and angulation of the gastroesophageal junction (GEJ) were determined; correlations between these determined parameters and symptoms were assessed using linear regression analysis...
February 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29549453/a-modified-nissen-fundoplication-subjective-and-objective-midterm-results
#10
Sabrina Rampado, Edoardo Savarino, Angelica Ganss, Giulia Pozza, Romeo Bardini
PURPOSE: The failure rate of laparoscopic anti-reflux surgery is approximately 10-20%. The aim of our prospective study was to investigate whether a modified Nissen fundoplication (MNF) can improve reflux symptoms and prevent surgical treatment failure in the midterm. METHODS: The MNF consisted of (1) suturing the esophagus to the diaphragmatic crura on each side using four non-absorbable stitches, (2) reinforcing clearly weak crura with a tailored Ultrapro mesh, and (3) fixing the upper stitch of the valve to the diaphragm...
March 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29471155/early-results-of-magnetic-sphincter-augmentation-versus-fundoplication-for-gastroesophageal-reflux-disease-systematic-review-and-meta-analysis
#11
REVIEW
Alberto Aiolfi, Emanuele Asti, Daniele Bernardi, Gianluca Bonitta, Emanuele Rausa, Stefano Siboni, Luigi Bonavina
BACKGROUND: Laparoscopic Nissen and Toupet fundoplication (LF) are currently considered gold-standard surgical treatment for Gastroesophageal Reflux Disease (GERD). Magnetic Sphincter Augmentation (MSA) is an innovative surgical procedure that has been showed to be effective to control GERD symptoms and to reduce esophageal acid exposure. The aim of this systematic review and meta-analysis was to compare early outcomes of LF and MSA. MATERIALS AND METHODS: PubMed, MEDLINE, Embase, and Cochrane databases were consulted matching the terms "Gastroesophageal reflux or heartburn", "LINX or magnetic sphincter augmentation" and "fundoplication"...
April 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29466120/a-modified-technique-to-create-a-standardized-floppy-nissen-fundoplication-without-a-bougie
#12
Petrus S S Castelijns, Marcel C G van de Poll, Johannes F Smulders
INTRODUCTION: Nissen fundoplication is frequently applied in the surgical treatment of patients with gastroesophageal reflux disease (GERD). When the gastroesophageal junction remains too large or becomes too narrow, persistent GERD or dysphagia may occur. To assure a correct size of the gastroesophageal junction, the fundoplication can be created over a bougie. However, this increases the risk of esophageal perforation. Therefore, we have modified a previously described technique to create a standardized fundoplication without the use of a bougie...
February 21, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29454100/patient-centered-outcomes-after-laparoscopic-paraesophageal-hernia-repair
#13
Tyler Hall, Natalie Warnes, Kristine Kuchta, Stephanie Novak, Herbert Hedberg, John G Linn, Stephen Haggerty, Woody Denham, Raymond J Joehl, Michael Ujiki
BACKGROUND: The aim of this study is to investigate patient-centered quality of life (QOL) outcomes in patients undergoing laparoscopic paraesophageal hernia repair. STUDY DESIGN: We prospectively followed patients who underwent laparoscopic paraesophageal hernia repair between 2009 and 2016. The QOL outcomes were measured using the 36-Item Short Form Health Survey, GERD Health Related Quality of Life, Reflux Symptom Index, and Dysphagia score surveys administered preoperatively and at 3 weeks, 6 months, 1 year, and 2 years postoperatively...
February 14, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29435755/surgical-management-of-gastroesophageal-reflux-disease-in-patients-with-systemic-sclerosis
#14
Jingliang Yan, Andrew T Strong, Gautam Sharma, Scott Gabbard, Prashanti Thota, John Rodriguez, Matthew Kroh
BACKGROUND: Systemic sclerosis (scleroderma) is frequently associated with both gastroesophageal reflux disease (GERD) and simultaneous esophageal dysmotility. Anti-reflux procedures in this patient population must account for the existing physiology of each patient and likely disease progression. We aim to compare perioperative and intermediate outcomes of fundoplication versus gastric bypass for the treatment of GERD. METHODS: After IRB approval, patients with systemic sclerosis undergoing fundoplication or gastric bypass for the treatment of GERD from 2004 to 2016 were identified...
February 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29423552/laparoscopic-management-of-large-hiatal-hernia-mesh-method-with-the-use-of-progrip-mesh-versus-standard-crural-repair
#15
V V Ilyashenko, Viktor V Grubnyk, V V Grubnik
BACKGROUND: Primary repair of large hiatal hernia is associated with a high recurrence rate. The use of mesh can lead to a reduce of recurrence rate. Despite this reduction, the type of mesh used and the placement technique are controversial. In our study, we used a new type of non-absorbable, self-fixating mesh to reinforce the cruroplasty. The aim of the present study was to compare the long-term results of laparoscopic treatment of large hiatal hernia with mesh reinforcement versus simple crura repair...
February 8, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29362910/roux-en-y-gastric-bypass-following-failed-fundoplication
#16
Kathleen M Coakley, Steven A Groene, Paul D Colavita, Tanushree Prasad, Dimitris Stefanidis, Amy E Lincourt, Vedra A Augenstein, Keith Gersin, B Todd Heniford
INTRODUCTION: Roux-En-Y gastric bypass (RYGB) is an alternative to reoperative fundoplication. The aim of this study was to expand long-term outcomes of patients undergoing RYGB after failed fundoplication and assess symptom resolution. METHODS: A single institution prospective study was performed of patients undergoing fundoplication takedown and RYGB between March 2007 and September 2016. Demographics, body mass index (BMI), preoperative symptoms, operative duration and findings, and postoperative outcomes were recorded...
January 23, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29351396/mechanisms-of-repetitive-retrograde-contractions-in-response-to-sustained-esophageal-distension-a-study-evaluating-patients-with-postfundoplication-dysphagia
#17
Dustin A Carlson, Peter J Kahrilas, Katherine Ritter, Zhiyue Lin, John E Pandolfino
Repetitive retrograde contractions (RRCs) in response to sustained esophageal distension are a distinct contractility pattern observed with functional luminal imaging probe (FLIP) panometry that are common in type III (spastic) achalasia. RRCs are hypothesized to be indicative of either impaired inhibitory innervation or esophageal outflow obstruction. We aimed to apply FLIP panometry to patients with postfundoplication dysphagia (a model of esophageal obstruction) to explore mechanisms behind RRCs. Adult patients with dysphagia after Nissen fundoplication ( n = 32) or type III achalasia ( n = 25) were evaluated with high-resolution manometry (HRM) and upper endoscopy with FLIP...
March 1, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29303805/randomized-trial-of-division-versus-nondivision-of-short-gastric-vessels-during-nissen-fundoplication-20-year-outcomes
#18
Stephen P Kinsey-Trotman, Peter G Devitt, Tim Bright, Sarah K Thompson, Glyn G Jamieson, David I Watson
OBJECTIVE: To evaluate late outcomes from a randomized trial of division versus no division of short gastric vessels during laparoscopic Nissen fundoplication at up to 20 years follow-up. BACKGROUND: Nissen fundoplication is an established procedure for the treatment of gastroesophageal reflux disease. Controversy about whether side effects such as dysphagia could be reduced by division of the short gastric vessels led to the establishment of a randomized trial in 1994...
January 4, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29234939/the-role-of-preoperative-high-resolution-manometry-in-predicting-dysphagia-after-laparoscopic-nissen-fundoplication
#19
Sonam Kapadia, Turner Osler, Allen Lee, Edward Borrazzo
BACKGROUND: Laparoscopic fundoplication is an accepted surgical management of refractory gastro-esophageal reflux disease (GERD). The use of high resolution esophageal manometry (HRM) in preoperative evaluation is often applied to determine the degree of fundoplication to optimize reflux control while minimizing adverse sequela of postoperative dysphagia. OBJECTIVE: Assess the role of preoperative HRM in predicting surgical outcomes, specifically risk assessment of postoperative dysphagia and quality of life, among patients receiving laparoscopic Nissen fundoplication for GERD with immediate postoperative (< 4 weeks clinic), short-term (3-month clinic), and long-term (34 ± 10...
December 12, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29156013/a-novel-strategy-to-initiate-a-peroral-endoscopic-myotomy-program
#20
J Matthew Reinersman, Dennis A Wigle, Christopher J Gostout, Louis M Wong Kee Song, Shanda H Blackmon
OBJECTIVES: The standard of care for achalasia remains laparoscopic Heller myotomy with partial fundoplication. Peroral endoscopic myotomy (POEM) has been introduced as an alternative, but safety and long-term comparative efficacy are not yet established. We report our experience in developing a POEM program using a novel hybrid approach. METHODS: We developed a hybrid approach to POEM with a POEM followed by laparoscopic evaluation, extension of the myotomy, if necessary, and partial fundoplication...
October 1, 2017: European Journal of Cardio-thoracic Surgery
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