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https://www.readbyqxmd.com/read/29667092/intraoperative-pyloric-interventions-during-oesophagectomy-a-multicentre-study
#1
Salvatore Marchese, Yassar A Qureshi, Shazia P Hafiz, Khaled Dawas, Paul Turner, M Muntzer Mughal, Borzoueh Mohammadi
BACKGROUND: Denervation of the pylorus after oesophagectomy is considered the principal factor responsible for delayed gastric emptying. Several studies have attempted to delineate whether surgical or chemical management of the pylorus during oesophagectomy is of benefit, but with conflicting results. The aim of this multicentre study was to assess whether there was any difference in outcomes between different approaches to management of the pylorus. METHODS: A prospectively maintained database was used to identify patients who underwent oesophagectomy for malignancy...
April 17, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29579257/pyloroplasty-may-reduce-weight-loss-1-year-after-esophagectomy
#2
K Harada, N Yoshida, Y Baba, K Nakamura, K Kosumi, T Ishimoto, M Iwatsuki, Y Miyamoto, Y Sakamoto, J A Ajani, M Watanabe, H Baba
Weight loss after esophagectomy is common and is associated with unfavorable prognosis. However, the clinical features and surgical methods that influence postesophagectomy weight loss are not well characterized. This study aims to determine those features (especially the surgical methods) that may affect postoperative weight loss. We reviewed 221 esophageal cancer patients who had undergone esophagectomy at Kumamoto University Hospital (Kumamoto, Japan) between November 2012 and June 2015. Among these, we recruited 106 patients who had undergone transthoracic esophagectomy with gastric conduit reconstruction, had no cancer recurrence within 1 year, and no missing follow-up data...
March 1, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29545738/subdiaphragmatic-vagotomy-with-pyloroplasty-ameliorates-the-obesity-caused-by-genetic-deletion-of-the-melanocortin-4-receptor-in-the-mouse
#3
Ghazaul Dezfuli, Richard A Gillis, Jaclyn E Tatge, Kimbell R Duncan, Kenneth L Dretchen, Patrick G Jackson, Joseph G Verbalis, Niaz Sahibzada
Background/Objectives: We tested the hypothesis that abolishing vagal nerve activity will reverse the obesity phenotype of melanocortin 4 receptor knockout mice ( Mc4r -/- ). Subjects/Methods: In two separate studies, we examined the efficacy of bilateral subdiaphragmatic vagotomy (SDV) with pyloroplasty in the prevention and treatment of obesity in Mc4r -/- mice. Results: In the first study, SDV prevented >20% increase in body weight (BW) associated with this genotype. This was correlated with a transient reduction in overall food intake (FI) in the preventative arm of the study...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29509543/management-of-pylorus-during-esophagectomy-to-drain-or-not-to-drain
#4
Stylianos Kykalos, Evangelia Ntikoudi
Dear Editor, delayed gastric emptying due to bilateral vagotomy after esophagectomy, has been associated with increased aspiration rates, prolonged hospital stay and impaired quality of life. A pyloric drainage procedure in an effort to reduce its incidence, most commonly a pyloroplasty, represented for years a standard part of distal esophagectomy. This trend has been reevaluated nowadays and the question that still remains open is whether we should further keep on draining pylorus during esophagectomy or not...
January 2018: Chirurgia
https://www.readbyqxmd.com/read/29509534/esophageal-reconstruction-with-the-stomach-a-functional-dilemma
#5
Dragoş Predescu, Silviu Constantinoiu
Background: A few decades ago, esophageal substitution was mainly dedicated particularly in postcaustic esophageal stenosis; currently, the reconstruction has expanded its palette of indications to other areas of benign esophageal pathology (severe motor disorders, esophageal achalasia with multiple relapses, peptic stenosis, etc.) but has also become a quasi-obligatory final time in the esophagectomy for cancer whenever it is possible. The techniques of esophageal reconstruction using the stomach, regardless of the indication and the chosen technical option, remain a valuable and effective method...
January 2018: Chirurgia
https://www.readbyqxmd.com/read/29490701/pylorus-drainage-procedures-in-thoracoabdominal-esophagectomy-a-single-center-experience-and-review-of-the-literature
#6
Stefan Fritz, Katharina Feilhauer, André Schaudt, Hansjörg Killguss, Eduard Esianu, René Hennig, Jörg Köninger
BACKGROUND: Pylorotomy and pyloroplasty in thoracoabdominal esophagectomy are routinely performed in many high-volume centers to prevent delayed gastric emptying (DGE) due to truncal vagotomy. Currently, controversy remains regarding the need for these practices. The present study aimed to determine the value and role of pyloric drainage procedures in esophagectomy with gastric replacement. METHODS: A retrospective review of prospectively collected data was performed for all consecutive patients who underwent thoracoabdominal resection of the esophagus between January 2009 and December 2016 at the Katharinenhospital in Stuttgart, Germany...
March 1, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29435660/indications-for-total-esophagogastric-dissociation-in-children-with-gastroesophageal-reflux-disease
#7
REVIEW
Yujiro Tanaka, Takahisa Tainaka, Hiroo Uchida
Total esophagogastric dissociation (TED) is used to treat gastroesophageal reflux (GER) after failed fundoplication in neurologically impaired patients. It is now performed for some otherwise healthy patients with severe GER. In this procedure, the gastrointestinal tract is reconstructed in a non-physiological way with a Roux-en-Y esophagojejunal anastomosis and jejuno-jejunostomy. Although TED eliminates almost all GER, some patients experience late complications. In this review, we investigated the long-term outcomes after TED to determine the best indications...
February 12, 2018: Surgery Today
https://www.readbyqxmd.com/read/29390430/congenital-diaphragmatic-hernia-in-association-with-congenital-short-esophagus-a-case-report
#8
Bo Xia, Chun Hong, Jing Tang, Cuifen Liu, Gang Yu
RATIONALE: Congenital diaphragmatic hernia (CDH) associated congenital anomalies are present in about 25%. Congenital short esophagus (CSE) is a relatively rare condition. Both CDH and congenital intrathoracic stomach caused by CSE can be diagnosed in utero. However, CSE can be easily misdiagnosed in utero. PATIENT CONCERNS: We present a case of left CDH with CSE in a female neonate who was diagnosed at 24 weeks gestational age by antenatal ultrasound. DIAGNOSES: The neonate with CDH and congenital intrathoracic stomach due to CSE was confirmed by operation...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29062455/laparoscopic-pyloroplasty-for-perforated-peptic-ulcer
#9
Edvard Grišin, Saulius Mikalauskas, Tomas Poškus, Valdemaras Jotautas, Kęstutis Strupas
Peptic ulcer is a common disease affecting millions of people every year. Despite improved understanding and treatment of the disease, the number of patients admitted with duodenal peptic ulcer perforation has not decreased. Deaths from peptic ulcer disease overcome other common emergency situations. Laparoscopic repair of the perforated peptic ulcer (PPU) is the gold standard approach for simple perforation. However, in patients with large perforated chronic ulcers laparotomy with pyloroplasty is the standard treatment...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29030799/gastric-peroral-endoscopic-pyloromyotomy-therapy-for-refractory-gastroparesis
#10
REVIEW
Petros C Benias, Mouen A Khashab
Purpose of review Gastroparesis is a complex dysmotility disorder in which a number of normal gastric emptying mechanisms can be affected. The pylorus as an apparatus is particularly important since it stands as the last final gateway for gastric emptying. As such, pyloric interventions seem to be successful in reducing symptoms and also improving emptying of solids, an effect not observed with other medical interventions. Recent findings Gastric peroral endoscopic myotomy (G-POEM) is a novel technique which offers the promise of mimicking the success of a traditional surgical pyloroplasty, while embracing the minimally invasive paradigm of flexible endoscopic surgery...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28758244/lung-transplantation-delays-gastric-motility-in-patients-without-prior-gastrointestinal-surgery-a-single-center-experience-of-412-consecutive-patients
#11
Sameer A Hirji, Brian C Gulack, Brian R Englum, Paul J Speicher, Asvin M Ganapathi, Asishana A Osho, Rahul A Shimpi, Alexander Perez, Matthew G Hartwig
PURPOSE: To examine the impact of lung transplantation on gastric motility. METHODS: Adult recipients at a large, single center, who were retrospectively evaluated with solid gastric emptying (SGE) study post-lung transplantation, but had no history of gastrointestinal intervention (ie, pyloroplasty or fundoplication), were selected between June 2005 and August 2013. Multivariable logistic regression was performed to determine risk factors associated with delayed gastric emptying (DGE) after transplantation...
July 31, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28756513/the-natural-history-of-perforated-foregut-ulcers-after-repair-by-omental-patching-or-primary-closure
#12
D Smith, M Roeser, J Naranjo, J A Carr
BACKGROUND: The treatment of perforated foregut ulcers by omental patching (OP) or primary closure has mostly replaced vagotomy and pyloroplasty/antrectomy (VPA). We sought to determine the natural history and recurrence rate of ulceration in patients treated by omental patching or primary closure. STUDY DESIGN: An 11-year retrospective study. RESULTS: From 2004 through 2015, 94 patients had perforated foregut ulcers, 53 gastric, and 41 duodenal...
July 29, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28752406/how-i-do-it-per-oral-pyloromyotomy-pop
#13
Matthew T Allemang, Andrew T Strong, Ivy N Haskins, John Rodriguez, Jeffrey L Ponsky, Matthew Kroh
INTRODUCTION: Several surgical treatments exist for treatment of gastroparesis, including gastric electrical stimulation, pyloroplasty, and gastrectomy. Division of the pylorus by means of endoscopy, Per-Oral Pyloromyotomy (POP), is a newer, endoluminal therapy that may offer a less invasive, interventional treatment option. METHODS: We describe and present a video of our step by step technique for POP using a lesser curvature approach. The following are technical steps to complete the POP procedure from the lesser curve approach...
November 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28726018/association-of-vagotomy-and-decreased-risk-of-subsequent-ischemic-stroke-in-complicated-peptic-ulcer-patients-an-asian-population-study
#14
Chu-Wen Fang, Chun-Hung Tseng, Shih-Chi Wu, William Tzu-Liang Chen, Chih-Hsin Muo
OBJECTIVES: The primary management of peptic ulcers is medical treatment. Persistent exacerbation of a peptic ulcer may lead to complications (perforation and/or bleeding). There has been a trend toward the use of a less invasive surgical simple suture, simple local suture or non-operative (endoscopic/angiography) hemostasis rather than acid-reducing vagotomy (i.e., vagus nerve severance) for treating complicated peptic ulcers. Other studies have shown the relationship between high vagus nerve activity and survival in cancer patients via reduced levels of inflammation, indicating the essential role of the vagus nerve...
December 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28689488/modified-laparoscopic-pyloroplasty-during-laparoscopic-splenectomy-and-azygoportal-disconnection-for-the-prevention-of-postoperative-gastroparesis
#15
Guoqing Jiang, Dousheng Bai, Jianjun Qian, Ping Chen, Shengjie Jin
BACKGROUND: Gastroparesis is a common complication after splenectomy and azygoportal disconnection, remaining a chronic debilitating disorder with considerable treatment challenges. To minimize postoperative gastroparesis, we have developed a new modified laparoscopic pyloroplasty (LP) technique for use during laparoscopic splenectomy and azygoportal disconnection (LSD). METHODS: We retrospectively evaluated the outcomes of 31 cirrhotic patients with portal hypertensive bleeding and secondary hypersplenism who underwent synchronous LSD with modified LP (n = 14) or LSD without modified LP (n = 17) between January 2015 and August 2015...
August 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28577248/pathological-findings-of-the-antral-and-pyloric-smooth-muscle-in-patients-with-gastroparesis-like-syndrome-compared-to-gastroparesis-similarities-and-differences
#16
COMPARATIVE STUDY
Mohammad Bashashati, Sharareh Moraveji, Alireza Torabi, Irene Sarosiek, Brian R Davis, Jesus Diaz, Richard W McCallum
BACKGROUND: Gastroparesis (GP)-like syndrome presents with the symptoms of GP but without delayed gastric emptying (GE). Whether GP-like syndrome is part of a spectrum of GP is not clear. This study aimed to compare the histopathological features of antral and pyloric smooth muscle tissue in GP and GP-like syndrome. METHODS: Full-thickness antral and/or pyloric biopsies were obtained from 37 GP and 18 GP-like syndrome patients who underwent abdominal surgery to place a gastric electrical stimulator or jejunal feeding tube and/or pyloroplasty...
October 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28576428/surgical-management-of-corrosive-induced-gastric-injury-in-children-10years-experience
#17
Khaled M El-Asmar, Ayman M Allam
AIM: The purpose of this study was to report surgical management and outcome of corrosive-induced gastric injuries in children at our institute over the last decade. PATIENTS & METHOD: Medical records of patients admitted for corrosive-induced gastric injury at the Pediatric Surgery Department of Ain Shams University between January 2007 and January 2017 were retrospectively reviewed. RESULTS: Twenty six cases (17 boys and 9 girls) were enrolled...
May 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28567693/per-oral-endoscopic-pyloromyotomy-for-refractory-gastroparesis-initial-results-from-a-single-institution
#18
John H Rodriguez, Ivy N Haskins, Andrew T Strong, Ryan L Plescia, Matthew T Allemang, Robert S Butler, Michael S Cline, Kevin El-Hayek, Jeffrey L Ponsky, Matthew D Kroh
INTRODUCTION: Gastroparesis is a debilitating disease characterized by delayed gastric emptying in the absence of mechanical obstruction. A new intramural technique, per oral endoscopic pyloromyotomy (POP), has been proposed as an alternative to surgical pyloroplasty for the management of medical refractory gastroparesis. Herein, we detail the short-term results of POP at our institution. METHODS: POP was first performed at our institution in January 2016. All patients undergoing POP for management of gastroparesis from January 2016 through January 2017 were prospectively followed...
December 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28481694/pyloroplasty-offers-relief-of-postfundoplication-gastroparesis-in-patients-who-improved-after-botulinum-toxin-injection
#19
Daniel Gilsdorf, Eric Volckmann, Abbie Brickley, Linda Jo Taylor, Robert E Glasgow, John Fang
BACKGROUND: Endoscopic intrapyloric Botox (onabotulinumtoxin A; Allergan Pharmaceuticals) injections can improve postfundoplication gastroparesis, but responses are not durable. Surgical pyloroplasty may relieve gastroparetic symptoms, but patient selection criteria are poorly defined. We hypothesize that pyloroplasty provides durable improvement in patients whose symptoms improved after Botox injection. STUDY DESIGN: A retrospective chart review was performed of patients with postfundoplication gastroparesis who improved after Botox injection and then underwent pyloroplasty...
November 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28375478/do-intraoperative-pyloric-interventions-predict-the-need-for-postoperative-endoscopic-interventions-after-minimally-invasive-esophagectomy
#20
COMPARATIVE STUDY
D N Giugliano, A C Berger, H Meidl, M J Pucci, E L Rosato, S W Keith, N R Evans, F Palazzo
Intraoperative pyloric procedures are often performed during esophagectomies to reduce the rates of gastric conduit dysfunction. They include pyloroplasty (PP), pyloromyotomy (PM), and pylorus botulinum toxin type-A injections (BI). Despite these procedures, patients frequently warrant further endoscopic interventions. The aim of this study is to compare intraoperative pyloric procedures and the rates of postoperative endoscopic interventions following minimally invasive esophagectomy (MIE). We identified patients who underwent MIE for esophageal carcinoma and grouped them as 'None' (no intervention), 'PP', 'PM', or 'BI' based on intraoperative pyloric procedure type...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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