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https://www.readbyqxmd.com/read/28623447/new-approaches-to-gastroesophageal-reflux-disease
#1
William Kethman, Mary Hawn
BACKGROUND: Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disorder of the esophagus. It is a chronic, progressive disorder that presents most typically with heartburn and regurgitation and atypically with chest pain, dysphagia, chronic cough, globus, or sore throat. The mainstay for diagnosis and characterization of the disorder is esophagoduodenoscopy (EGD), high-resolution esophageal manometry, and symptom-associated ambulatory esophageal pH impedance monitoring...
June 16, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28616302/esophagogastric-junction-outflow-obstruction-related-functional-chest-pain-treated-using-robotic-assisted-thoracoscopic-esophageal-myotomy
#2
Kuan-Hsun Lin, Shih-Chun Lee, Tsai-Wang Huang, Hsu-Kai Huang
Elevated relaxation pressure in combination with intact or weak peristalsis characterizes esophagogastric junction (EGJ) outflow obstruction. Symptoms of EGJ outflow obstruction include dysphagia and atypical chest pain. EGJ outflow obstruction can be diagnosed using high-resolution manometry (HRM), but there is a lack of consensus regarding treatment. We present a case report of a 43-year-old man with a history of headache and mitral valve disorder who suffered from intermittent atypical chest pain for 20 years...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28604517/espghan-guidelines-for-the-evaluation-and-treatment-of-gastrointestinal-and-nutritional-complications-in-children-with-neurological-impairment
#3
Claudio Romano, Myriam van Wynckel, Jessie Hulst, Ilse Broekaert, Jiri Bronsky, Luigi Dall'Oglio, Nataša Fidler Mis, Iva Hojsak, Rok Orel, Alexandra Papadopoulou, Michela Schaeppi, Nikhil Thapar, Michael Wilschanski, Peter Sullivan, Frédéric Gottrand
OBJECTIVES: Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia and nutritional comorbidites. Gastrointestinal problems including gastroesophageal reflux disease, constipation and dysphagia are also very frequent in this population and impact quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, ESPGHAN aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in neurologically impaired chidren...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28586287/esophageal-penetration-of-the-magnetic-sphincter-augmentation-device-history-repeats-itself
#4
Renato Salvador, Mario Costantini, Giovanni Capovilla, Lino Polese, Stefano Merigliano
BACKGROUND: An alternative approach to the treatment of gastroesophageal reflux disease (GERD) has recently been introduced in clinical practice, involving the implantation of a magnetic sphincter augmentation device (MSAD). This "magnetic ring" is implanted laparoscopically around the lower esophageal sphincter to improve its barrier function. The literature is still limited on the midterm results achieved in controlling reflux because the MSAD is a very new procedure. So far, only a few cases of the MSAD causing erosion of the esophagus have been reported...
June 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28575249/esophageal-distensibility-measurement-impact-on-clinical-management-and-procedure-length
#5
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/28575245/peroral-endoscopic-myotomy-versus-surgical-myotomy-for-primary-achalasia-single-center-retrospective-analysis-of-74-patients
#6
S de Pascale, A Repici, F Puccetti, E Carlani, R Rosati, U Fumagalli
Achalasia is a neurodegenerative motility disorder of the esophagus; dysphagia, weight loss, chest pain, and regurgitation are its main symptoms. Surgical myotomy (HM) is considered the gold standard treatment. However, peroral endoscopic myotomy (POEM) seems to be a safe and effective alternative option. The aim of this study is to compare the safety and efficacy of these techniques. From March 2012 to June 2015, 74 patients with symptomatic primary achalasia underwent myotomy. The two groups were compared in terms of intraoperative and postoperative outcomes and Eckardt score at last follow-up...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28466002/efficacy-of-magnetic-sphincter-augmentation-versus-nissen-fundoplication-for-gastroesophageal-reflux-disease-in-short-term-a-meta-analysis
#7
REVIEW
Ming-Yu Chen, Di-Yu Huang, Angela Wu, Yi-Bin Zhu, He-Pan Zhu, Liu-Mei Lin, Xiu-Jun Cai
Background. The efficacy of Magnetic Sphincter Augmentation (MSA) and its outcomes for Gastroesophageal Reflux Disease (GERD) are uncertain. Therefore, we aimed to summarize and analyze the efficacy of two treatments for GERD. Methods. The meta-analysis search was performed, using four databases. All studies from 2005 to 2016 were included. Pooled effect was calculated using either the fixed or random effects model. Results. A total of 4 trials included 624 patients and aimed to evaluate the differences in proton-pump inhibitor use, complications, and adverse events...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28445106/tension-free-inlay-repair-of-large-hiatal-hernias-using-dual-sided-composite-ptfe-eptfe-meshes-in-laparoscopic-surgery-for-gastroesophageal-reflux-disease
#8
Alexander M Prusa, Ivan Kristo, Erwin Rieder, Claudia Ringhofer, Reza Asari, Johannes Miholic, Sebastian F Schoppmann
BACKGROUND: Patients with gastroesophageal reflux disease (GERD) also frequently suffer from concomitant hiatal hernia. It has been described that a preoperative hiatal hernia of ≥3 cm is associated with a more than threefold relative risk for reflux symptom recurrence after fundoplication without mesh reinforcement. In this report, we describe our experience with the implantation of dual-sided composite PTFE/ePTFE meshes in a tension-free fashion during laparoscopic antireflux surgery (LARS)...
April 26, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28437314/outcome-for-patients-with-pathological-esophageal-acid-exposure-after-laparoscopic-fundoplication
#9
Jelmer E Oor, Vincent B Nieuwenhuijs, Peter G Devitt, Eric J Hazebroek, David I Watson
OBJECTIVE: The aim of the current study was to assess symptomatic outcome and need for surgical reintervention for patients identified with pathological esophageal acid exposure by routine postoperative 24-hour pH-monitoring. BACKGROUND: Although laparoscopic fundoplication is associated with excellent short- and midterm results, recurrent symptoms pose an important challenge. Postoperative pH-monitoring is considered the "gold standard" for diagnosing recurrent GERD and frequently used for routine postoperative follow up...
April 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28430558/lower-esophageal-sphincter-augmentation-for-gastroesophageal-reflux-disease-the-safety-of-a-modern-implant
#10
C Daniel Smith, Robert A Ganz, John C Lipham, Reginald C Bell, David W Rattner
INTRODUCTION: Use of the magnetic sphincter augmentation device (MSAD) for gastroesophageal reflux disease (GERD) is increasing. As this innovative treatment for GERD gains widespread use and adoption, an assessment of its safety since U.S. market introduction is presented. METHODS: Events were collected from the Manufacturer and User Facility Device Experience (MAUDE) database, which reports events submitted to the Food and Drug Administration (FDA) of suspected device-associated deaths, serious injuries, and malfunctions...
June 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28424985/postoperative-complications-and-functional-outcome-after-esophageal-atresia-repair-results-from-longitudinal-single-center-follow-up
#11
Florian Friedmacher, Birgit Kroneis, Andrea Huber-Zeyringer, Peter Schober, Holger Till, Hugo Sauer, Michael E Höllwarth
BACKGROUND: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) represent major therapeutic challenges, frequently associated with serious morbidities following surgical repair. The aim of this longitudinal study was to assess temporal changes in morbidity and mortality of patients with EA/TEF treated in a tertiary-level center, focusing on postoperative complications and their impact on long-term gastroesophageal function. METHODS: One hundred nine consecutive patients with EA/TEF born between 1975 and 2011 were followed for a median of 9...
April 19, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28416923/esophageal-achalasia-predictive-value-of-preoperative-resting-pressure-of-les-correlated-with-type-of-fundoplication
#12
Antonio Tancredi, Antonello Cuttitta, Roberto Scaramuzzi, Gerardo Scaramuzzi, Marco Taurchini
OBJECTIVE: The aim of the present study is to show the predictive value of the preoperative resting pressure of the lower esophageal sphincter (LES) correlated with the type of fundoplication (Nissen or Dor) after Heller myotomy in our series. MATERIALS AND METHODS: From January 1998 to June 2010, 88 patients affected by esophageal achalasia underwent surgery at our unit. However, our study focused on a sample of 36 patients, because many data were lost or was never recorded...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28389792/laparoscopic-redo-fundoplication-improves-disease-specific-and-global-quality-of-life-following-failed-laparoscopic-or-open-fundoplication
#13
Sara E Martin Del Campo, Sara A Mansfield, Andrew J Suzo, Jeffrey W Hazey, Kyle A Perry
INTRODUCTION: Laparoscopic fundoplication is associated with failure rates of up to 30% and redo operation rates of 5-8%. Redo fundoplication improves patient symptoms, but its impact on patient quality of life remains unclear. We hypothesized that laparoscopic redo fundoplication improves disease-specific and global quality of life in patients with recurrent symptoms following failed laparoscopic or open fundoplication. METHODS: Data for all patients undergoing a redo fundoplication between August 2009 and June 2014 were collected prospectively...
April 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28375480/same-day-discharge-in-benign-esophageal-surgery-a-prospective-cohort-study
#14
A Desbeaux, C Gronnier, G Piessen, M Vanderbeken, N Ruolt, J-P Triboulet, C Mariette
Day-case esophageal surgery has been demonstrated to be safe in small prospective cohorts and only for laparoscopic fundoplication. The aims of this study are to assess the feasibility and safety of a large series of esophageal day-case surgeries, including laparoscopic Nissen fundoplication (LNF), Zenker diverticulectomy (ZD), and laparoscopic Heller myotomy (LHM) and to compare the outcomes among three procedures.This was a prospective, observational study of selected patients who underwent day-case LNF, ZD, and LHM between 2003 and 2013...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375479/temporal-patterns-of-hiatus-hernia-recurrence-and-hiatal-failure-quality-of-life-and-recurrence-after-revision-surgery
#15
A Suppiah, P Sirimanna, S J Vivian, H O'Donnell, G Lee, G L Falk
Antireflux and paraesophageal hernia repair surgery is increasingly performed and there is an increased requirement for revision hiatus hernia surgery. There are no reports on the changes in types of failures and/or the variations in location of crural defects over time following primary surgery and limited reports on the outcomes of revision surgery. The aim of this study is to report the changes in types of hernia recurrence and location of crural defects following primary surgery, to test our hypothesis of the temporal events leading to hiatal recurrence and aid prevention...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28317316/severely-impaired-gastric-accommodation-is-a-hallmark-of-post-nissen-functional-dyspepsia-symptoms
#16
A Pauwels, V Boecxstaens, C Broers, J F Tack
BACKGROUND: Laparoscopic Nissen fundoplication is a commonly performed antireflux surgery, after which reflux symptoms are well controlled, however, complications such as inability to belch or dyspeptic symptoms (mimicking those of functional dyspepsia [FD]) might occur. The aim of the study was to prospectively evaluate symptom pattern and underlying pathophysiological mechanisms in patients with post-Nissen dyspepsia. METHODS: Twenty-four patients (12 f, mean age 44...
March 20, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28295217/randomized-clinical-trial-of-270%C3%A2-posterior-versus-180%C3%A2-anterior-partial-laparoscopic-fundoplication-for-gastro-oesophageal-reflux-disease
#17
D J Roks, J H Koetje, J E Oor, J A Broeders, V B Nieuwenhuijs, E J Hazebroek
BACKGROUND: Partial fundoplications provide similar reflux control with fewer post-fundoplication symptoms compared with Nissen fundoplication for gastro-oesophageal reflux disease (GORD). The best choice of procedure for partial fundoplication remains unclear. The aim of this study was to compare the outcome of two different types of partial fundoplication for GORD. METHODS: A double-blind RCT was conducted between 2012 and 2015 in two hospitals specializing in antireflux surgery...
June 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28294958/seventeen-year-outcome-of-a-randomized-clinical-trial-comparing-laparoscopic-and-conventional-nissen-fundoplication-a-plea-for-patient-counseling-and-clarification
#18
Jelmer E Oor, David J Roks, Joris A Broeders, Eric J Hazebroek, Hein G Gooszen
OBJECTIVE: To analyze long-term outcome of a randomized clinical trial comparing laparoscopic Nissen fundoplication (LNF) and conventional Nissen fundoplication (CNF) for the treatment of gastroesophageal reflux disease (GERD). BACKGROUND: LNF has replaced CNF, based on positive short and mid-term outcome. Studies with a follow-up of over 15 years are scarce, but are desperately needed for patient counselling. METHODS: Between 1997 and 1999, 177 patients with proton pump inhibitor (PPI)-refractory GERD were randomized to CNF or LNF...
July 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28258450/does-nissen-fundoplication-provide-lifelong-reflux-control-symptomatic-outcome-after-31-33-years
#19
P Neuvonen, J Sand, M Matikainen, T Rantanen
BACKGROUND: A substantial number of people are suffering from gastroesophageal reflux disease (GERD). The indication for surgical treatment is the failure of medical treatment in patients with objectively verified GERD. The use of PPIs has been noted to increase with the length of follow-up after fundoplication, raising questions concerning the durability of surgical results. The aim of the study was to investigate the results of open Nissen fundoplication (ONF) over a follow-up of more than 31 years...
March 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28252352/fundoplication-for-laryngopharyngeal-reflux-despite-preoperative-dysphagia
#20
G L Falk, H Van der Wall, L Burton, M G Falk, H O'Donnell, S J Vivian
INTRODUCTION Fundoplication for laryngopharyngeal disease with oesophageal dysmotility has led to mixed outcomes. In the presence of preoperative dysphagia and oesophageal dysmotility, this procedure has engendered concern in certain regards. METHODS This paper describes a consecutive series of laryngopharyngeal reflux (LPR) patients with a high frequency of dysmotility. Patients were selected for surgery with 24-hour dual channel pH monitoring, oesophageal manometry and standardised reflux scintigraphy. RESULTS Following careful patient selection, 33 patients underwent fundoplication by laparoscopy...
March 2017: Annals of the Royal College of Surgeons of England
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