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Pyloroplasty

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https://www.readbyqxmd.com/read/28481694/pyloroplasty-offers-relief-of-postfundoplication-gastroparesis-in-patients-who-improved-after-botulinum-toxin-injection
#1
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...
May 8, 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
#2
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
https://www.readbyqxmd.com/read/28124202/pyloric-therapies-for-gastroparesis
#3
REVIEW
Nitin K Ahuja, John O Clarke
Gastroparesis is a syndrome that can be difficult to treat effectively and likely represents the common clinical presentation of multiple underlying mechanisms. One of these presumed mechanisms involves pyloric dysfunction, tied perhaps to spasm or fibrosis, manifesting as functional gastric outlet obstruction. Various diagnostic modalities have been used to better characterize this hypothesized abnormality, including most recently antroduodenal manometry and impedance planimetry. A variety of therapeutic interventions specific to the pylorus have also been proposed in the last several years, including intrapyloric injections of botulinum toxin, transpyloric stenting, surgical pyloroplasty, and endoscopic pyloromyotomy...
March 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28058546/is-chemical-pyloroplasty-necessary-for-minimally-invasive-esophagectomy
#4
Camille L Stewart, Lauren Wilson, Aidan Hamm, Christan Bartsch, Megan Boniface, Ana Gleisner, John D Mitchell, Michael J Weyant, Robert Meguid, Csaba Gajdos, Barish H Edil, Martin McCarter
BACKGROUND: Many centers use botulinum toxin for chemical pyloroplasty in minimally invasive esophagectomies as prophylaxis against delayed gastric emptying. No previous studies have compared botulinum toxin injection with no pyloric intervention for patients treated with a combined laparoscopic and thoracoscopic approach. The authors hypothesized that chemical pyloroplasty does not improve outcomes for these patients. METHODS: The study investigated patients undergoing minimally invasive esophagectomies from September 2009 to June 2015...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28055335/tubularized-gastric-conduit-is-more-desirable-in-pediatric-patients-treated-with-minimally-invasive-esophagectomy-and-gastric-pull-up
#5
Shannon L Castle, Mubina Isani, Manuel B Torres, Dean M Anselmo, Nam X Nguyen
INTRODUCTION: Conditions requiring an esophagectomy and esophageal replacement are rare in children. The preferred method and ideal replacement organ continue to be debated. We present long-term outcomes in children treated with esophagectomy and gastric pull-up. METHODS: We conducted a retrospective review of all the patients who underwent a esophagectomy and gastric pull-up at two major pediatric institutions from 2004 to 2015. Follow-up data were obtained for children when available, including any postoperative complications, need for dilation of strictures, and current feeding method...
April 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27994010/successful-surgical-excision-of-a-massive-symptomatic-partially-obstructing-brunner-s-gland-hamartoma-a-case-report
#6
Khortnal Delvecchio, Susan Seman
Brunner gland function within the duodenal epithelium is secretion of alkaline mucin to counteract acidic chyme. These glands may grow beyond the duodenal wall to become hamartomas. Rarely, they become large enough to cause obstructive symptoms in the upper gastrointestinal tract. We report a case of one of the largest lesions identified in the literature causing obstruction symptoms. A previously asymptomatic 65-year-old gentleman presented to the emergency department with a single-day history of colicky abdominal pain, cramping and vomiting...
December 18, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27957308/single-incision-laparoscopy-surgery-a-systematic-review
#7
REVIEW
Sasan Saeed Far, Sepide Miraj
BACKGROUND: Laparoscopic surgery is a modern surgical technique in which operations are performed far from their location through small incisions elsewhere in the body. OBJECTIVE: This systematic review is aimed to overview single-incision laparoscopy surgery. METHODS: This systematic review was carried out by searching studies in PubMed, Medline, Web of Science, and IranMedex databases. The initial search strategy identified about 87 references...
October 2016: Electronic Physician
https://www.readbyqxmd.com/read/27896652/the-long-term-efficacy-and-safety-of-pyloroplasty-combined-with-gastric-electrical-stimulation-therapy-in-gastroparesis
#8
Brian R Davis, Irene Sarosiek, Mohammad Bashashati, Ben Alvarado, Richard W McCallum
INTRODUCTION: Gastroparesis is delayed gastric emptying without mechanical obstruction. Symptomatic improvement can be 50-60% with gastric electrical stimulation. To address delayed gastric emptying, pyloroplasty was added. This study examines the long-term efficacy and safety of simultaneous gastric electrical stimulator implantation and pyloroplasty. METHODS: In this prospective single-arm trial conducted from 2012 to 2015, 27 [23 females; mean age 43 (22-63)] gastroparesis patients who underwent simultaneous gastric electrical stimulator implantation with Heineke-Mikulicz pyloroplasty were studied...
November 28, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27757585/vomiting-in-an-infant-with-congenital-nephrotic-syndrome-questions
#9
Toshiyuki Takahashi, Yasuyuki Sato, Takeshi Yamazaki, Asako Hayashi, Takayuki Okamoto
BACKGROUND: Most patients with congenital nephrotic syndrome (CNS) exhibit a failure to thrive. A previous study reported that five of 41 (12 %) infants with CNS had hypertrophic pyloric stenosis (HPS) requiring surgery. The reason for this is undetermined, and there are few reports regarding the relationship between these conditions or their clinical course. CASE DIAGNOSIS/TREATMENT: We present the case of a 4-month-old girl with CNS. She did not show typical manifestations of HPS, but thickened mucosal and submucosal layers and hypertrophy of the pyloric muscle were detected by repeated ultrasound examinations prior to the diagnosis of HPS...
October 18, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27680064/-study-on-the-association-of-gastric-conduit-width-and-postoperative-early-delayed-gastric-emptying-in-middle-lower-esophageal-cancer-patients-undergoing-ivor-lewis-procedure
#10
Fuxi Zhen, Sailei Shi, Lei Xue, Jinyuan Liu, Jinhua Luo
OBJECTIVE: To examine the relationship between gastric conduit width and postoperative early delayed gastric emptying (DGE) in patients with middle-lower esophageal carcinoma who underwent Ivor-Lewis operation. METHODS: Clinical data of 282 consecutive patients with middle-lower esophageal cancer who underwent the Ivor-Lewis operation by same surgical team in our department from January 2013 to June 2015 were retrospectively analyzed. Patients were divided into three groups according to the width of gastric conduit: width > 5...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27679942/influence-of-duodenogastric-reflux-in-the-gastric-mucosa-histological-changes-of-rats-infected-with-helicobacter-pylori
#11
José Carlos Ribeiro DE Araujo, Jorge José DE Carvalho, Humberto Oliveira Serra
OBJECTIVE: to evaluate the influence of Duodenal reflux in histological changes of the gastric mucosa of rats infected with Helicobacter pylori submitted to pyloroplasty. METHODS: after two weeks of acclimation, we infected 30 male Wistar rats with Helicobacter pylori. We randomly divided them into three groups: one submitted to pyloroplasty, another to partial gastrectomy and the third, only infected, was not operated. After six months of surgery, euthanasia was carried out...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27294093/laparoscopic-finney-pyloroplasty-in-the-emergency-setting-first-case-report-in-the-literature-and-technical-challenges
#12
Elisabetta Moggia, Panagiotis G Athanasopoulos, Christopher Hadjittofi, Stefano Berti
Pyloroplasty is currently reserved for emergencies (perforation, bleeding), but may occasionally be performed to treat benign gastric outlet obstruction (GOO). Historically, two techniques are available: the Mikulicz pyloroplasty, by which the pylorus is incised longitudinally and sutured vertically, and the Finney pyloroplasty, by which a U-shaped inverted incision is made in the second part of duodenum (D1-D2), followed by a side-to-side gastroduodenostomy. We report our experience in this single case of laparoscopic Finney pyloroplasty (LFP) performed in the emergency setting for a woman with a perforated duodenal ulcer and severe loss of tissue in D1-D2...
May 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27222546/roles-of-the-gut-in-glucose-homeostasis
#13
REVIEW
Jens Juul Holst, Fiona Gribble, Michael Horowitz, Chris K Rayner
The gastrointestinal tract plays a major role in the regulation of postprandial glucose profiles. Gastric emptying is a highly regulated process, which normally ensures a limited and fairly constant delivery of nutrients and glucose to the proximal gut. The subsequent digestion and absorption of nutrients are associated with the release of a set of hormones that feeds back to regulate subsequent gastric emptying and regulates the release of insulin, resulting in downregulation of hepatic glucose production and deposition of glucose in insulin-sensitive tissues...
June 2016: Diabetes Care
https://www.readbyqxmd.com/read/27221182/-gastroparesis-causes-diagnosis-and-treatment
#14
REVIEW
Dag A Sangnes, Eirik Søfteland, Martin Biermann, Odd Helge Gilja, Hrafnkell Thordarson, Georg Dimcevski
BACKGROUND Gastroparesis is a motility disorder of the stomach. The symptoms are non-specific: nausea and vomiting are most common. Stomach pains, early satiety, postprandial fullness and bloating are also frequent symptoms. Current diagnostic criteria require delayed gastric emptying in the absence of any detectable mechanical obstruction. In this review article we elucidate the causes, assessment and treatment options.MATERIAL AND METHOD Structured article search in Embase and PubMed.RESULTS A number of conditions can lead to gastroparesis...
May 2016: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/27197717/gastric-peroral-endoscopic-pyloromyotomy-g-poem-as-a-salvage-therapy-for-refractory-gastroparesis-a-case-series-of-different-subtypes
#15
P Mekaroonkamol, L Y Li, S Dacha, Y Xu, S D Keilin, F F Willingham, Q Cai
BACKGROUND: Gastroparesis is a poorly understood, chronic, debilitating motility disorder with very limited medical therapeutic options. Gastric peroral endoscopic pyloromyotomy (G-POEM) is an emerging novel endoscopic technique as an incisionless pyloroplasty for refractory cases. Effective information of G-POEM on different types of gastroparesis is sparse. METHODS: Cases of G-POEM using selective circular myotomy as a salvage therapy for refractory symptoms were retrospective studied...
August 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27116690/congenital-pyloric-atresia-early-and-delayed-presentations-a-single-centre-experience-of-a-rare-anomaly
#16
Pradeep Kajal, Kamal Nain Rattan, Namita Bhutani, Poonam Yadav
Pyloric atresia may occur as an isolated or pure atresia or may be associated with other anomalies like those involving skin, renal or gastrointestinal systems etc. The most frequent association is with junctional epidermolysis bullosa, a rare autosomal recessive disorder affecting the skin and mucosa. We present a prospective evaluation of three patients of pyloric atresia at our institute over last 2 years (2012-2014)-one of them presenting at 5th day of life and the other two at 5 and 6 years of age, respectively...
May 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/27096790/laparoscopic-pyloromyotomy-and-pyloroplasty-in-dogs
#17
P Holak, H Matyjasik, M Jałyński, Z Adamiak, M Jaskólska
This article describes clinical experiments involving laparoscopic pyloromyotomy and pyloroplasty in six dogs diagnosed with hypertrophy of the pyloric sphincter. Laparoscopic pyloromyotomy was performed in three dogs, and pyloroplasty was carried out in the remaining three animals. The patients were operated on based on the authors' previous experiences with experimental pyloromyotomy and pyloroplasty in pigs. Pyloromyotomy and pyloroplasty resulted in full recovery and complete subsidence of symptoms in all patients...
2016: Polish Journal of Veterinary Sciences
https://www.readbyqxmd.com/read/27094564/laparoscopy-assisted-proximal-gastrectomy-with-the-hinged-double-flap-method
#18
Atsushi Muraoka, Masahiko Kobayashi, Yasutaka Kokudo
BACKGROUND: No standard proximal gastrectomy method for gastric cancer of the upper third of the stomach (UGC) has been established because few of the current methods prevent gastro-esophageal reflux and allow easy postoperative endoscopic surveillance. In the present study, we describe laparoscopic proximal gastrectomy with the hinged double flap method (Kamikawa's method) in detail and examine the short- to medium-term outcomes of this approach, which resulted in excellent postoperative function...
October 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27053537/choleduodenal-fistula-with-gastric-outlet-obstruction
#19
Matthew Dong, Alfredo Daniel Guerron, Gareth Morris-Stiff, Sricharan Chalikonda
Bouveret's syndrome, cholecystoduodenal fistula with gastric outlet obstruction secondary to an impacted gallstone, is a rare but serious complication of cholelithiasis. We report the case of a 69-year-old woman who presented with epigastric pain and vomiting in whom cross-sectional imaging revealed a duodenal mass with cholecystoduodenal fistula and pneumobilia. Endoscopic evaluation identified a large gallstone obstructing the pyloric channel. She underwent laparotomy and stone extraction with pyloroplasty, had an unremarkable recovery...
April 6, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27043862/intraoperative-endoscopic-botox-injection-during-total-esophagectomy-prevents-the-need-for-pyloromyotomy-or-dilatation
#20
Hans F Fuchs, Ryan C Broderick, Cristina R Harnsberger, Francisco Alvarez Divo, Alisa M Coker, Garth R Jacobsen, Bryan J Sandler, Michael Bouvet, Santiago Horgan
BACKGROUND: Esophagectomy may lead to impairment in gastric emptying unless pyloric drainage is performed. Pyloric drainage may be technically challenging during minimally invasive esophagectomy and can add morbidity. We sought to determine the effectiveness of intraoperative endoscopic injection of botulinum toxin into the pylorus during robotic-assisted esophagectomy as an alternative to surgical pyloric drainage. MATERIALS AND METHODS: We performed a retrospective analysis of patients with adenocarcinoma and squamous cell carcinoma of the distal esophagus or gastroesophageal junction who underwent robotic-assisted transhiatal esophagectomy (RATE) without any surgical pyloric drainage...
June 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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