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Per oral endoscopic myotomy

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https://www.readbyqxmd.com/read/28235595/an-international-multicenter-study-evaluating-the-clinical-efficacy-and-safety-of-per-oral-endoscopic-myotomy-in-octogenarians
#1
Yen-I Chen, Haruhiro Inoue, Michael Ujiki, Peter V Draganov, Paul Colavita, Francois Mion, John Romanelli, Philip Chiu, Valerio Balassone, Lava Patel, Ali Abbas, Dennis Yang, Christy Dunst, Mathieu Pioche, Sabine Roman, Jérôme Rivory, Thierry Ponchon, David Desilets, Roberta Maselli, Manabu Onimaru, Jun Nakamura, Yoshitaka Hata, Gulara Hajiyeva, Amr Ismail, Saowanee Ngamruengphong, Majidah Bukhari, Yamile Haito Chavez, Vivek Kumbhari, Alessandro Repici, Mouen A Khashab
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) for achalasia is particularly appealing in the elderly due to its minimally invasiveness; however, data in patients age ≥ 80 years are scarce. The aim of this study was to assess the clinical outcome of POEM in octogenarians. METHODS: Multicenter retrospective study at 8 centers. Consecutive octogenarians with achalasia who underwent POEM between 2010 and 2016 were included. Rates of technical success (completion of myotomy), clinical response (Eckardt score ≤3), and adverse events (AEs) (severity graded as per American Society for Gastrointestinal Endoscopy [ASGE] lexicon) were assessed...
February 21, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28188367/current-status-of-achalasia-management-a-review-on-diagnosis-and-treatment
#2
REVIEW
Joshua Tuason, Haruhiro Inoue
BACKGROUND: Achalasia is a rare esophageal motility disorder that is characterized by loss of peristalsis and failure of relaxation of the lower esophageal sphincter (LES), particularly during swallowing. This review focuses on the diagnosis of esophageal motility disorders as defined by the Chicago Classification ver 3.0, and presents management options with regard to per-oral endoscopic myotomy (POEM) as the treatment of choice. METHODS: A concise review of literature was performed for articles related to the management of achalasia, and this was contrasted with our institution's current practice...
February 10, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28161449/outcomes-and-quality-of-life-assessment-after-gastric-per-oral-endoscopic-pyloromyotomy-with-video
#3
Sunil Dacha, Parit Mekaroonkamol, Lianyong Li, Nikrad Shahnavaz, Sonali Sakaria, Steven Keilin, Field Willingham, Jennifer Christie, Qiang Cai
BACKGROUND AND AIM: Gastric per-oral endoscopic pyloromyotomy (GPOEM) is emerging as a promising option for the treatment of gastroparesis. This study assessed outcomes and quality-of-life after GPOEM for gastroparesis, performed in an endoscopy unit at a major tertiary referral center. METHODS: We performed a retrospective review of patients who had undergone GPOEM during June 2015 to July 2016. Data were collected from electronic medical records including patient demographics, endoscopy records, hospitalization records, clinic visits, and electronic messages...
February 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28151769/per-oral-endoscopic-myotomy-in-a-child-with-achalasia-cardia
#4
Zaheer Nabi, Mohan Ramchandani, D Nageshwar Reddy
No abstract text is available yet for this article.
February 1, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28052278/diagnosis-and-treatment-strategy-of-achalasia-subtypes-and-esophagogastric-junction-outflow-obstruction-based-on-high-resolution-manometry
#5
REVIEW
Eikichi Ihara, Kazumasa Muta, Keita Fukaura, Kazuhiko Nakamura
BACKGROUND: Based on Chicago Classification version 3.0, the disorders of esophagogastric junction outflow obstruction (EGJOO) include achalasia (types I, II and III) and EGJOO. Although no curative treatments are currently available for the treatment of the disorders of EGJOO, medical treatments, endoscopic pneumatic dilation (PD), laparoscopic Heller myotomy (LHM), and per-oral endoscopic myotomy (POEM) are usually the sought-after modes of treatment. Since the etiology and pathogenesis might vary depending on the types of EGJOO disorders, treatment strategies should be considered based on those subtypes...
2017: Digestion
https://www.readbyqxmd.com/read/27921057/endoscopic-management-of-an-intramural-sinus-leak-after-per-oral-endoscopic-myotomy
#6
Haider Al Taii, Bradley Confer, Scott Gabbard, Matthew Kroh, Sunguk Jang, John Rodriguez, Mansour A Parsi, John J Vargo, Jeffrey Ponsky, Amit Bhatt
Per-oral endoscopic myotomy (POEM) was developed less than a decade ago for the treatment of achalasia. Its minimally invasive approach and the favorable short-term outcome have led to rapid adoption of the technique throughout the world. As with any new technique, there will be adverse events, and it is important that effective treatments for these adverse events be discussed. We present a case of successful endoscopic management of an intramural sinus leak after a POEM procedure using tandem fully covered esophageal stents...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27909548/microvasculature-of-the-esophagus-and-gastroesophageal-junction-lesson-learned-from-submucosal-endoscopy
#7
REVIEW
Roberta Maselli, Haruhiro Inoue, Haruo Ikeda, Manabu Onimaru, Akira Yoshida, Esperanza Grace Santi, Hiroki Sato, Bu'Hussain Hayee, Shin-Ei Kudo
Advanced therapeutic endoscopy, in particular endoscopic mucosal resection, endoscopic submucosal dissection, per-oral endoscopic myotomy, submucosal endoscopic tumor resection opened a new era where direct esophageal visualization is possible. Combining these information with advanced diagnostic endoscopy, the esophagus is organized, from the luminal side to outside, into five layers (epithelium, lamina propria with lamina muscularis mucosa, submucosa, muscle layer, adventitia). A specific vascular system belonging to each layer is thus visible: Mucosa with the intra papillary capillary loop in the epithelium and the sub-epithelial capillary network in the lamina propria and, at the lower esophageal sphincter (LES) level with the palisade vessels; submucosa with the drainage vessels and the spindle veins at LES level; muscle layer with the perforating vessels; peri-esophageal veins in adventitia...
November 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27868244/ddw-2016-review-advances-in-therapeutic-upper-gastrointestinal-endoscopy
#8
REVIEW
Shannon Melissa Chan, Baldwin Yeung, Philip Wai Yan Chiu
This is a review of the abstracts presented at Digestive Disease Week 2016, 21-24 May 2016 in San Diego, CA, USA, focusing on novel advances in therapeutic endoscopy of the upper gastrointestinal tract.
November 21, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27858325/is-poem-the-answer-for-management-of-spastic-esophageal-disorders-a-systematic-review-and-meta-analysis
#9
REVIEW
Muhammad Ali Khan, Vivek Kumbhari, Saowanee Ngamruengphong, Amr Ismail, Yen-I Chen, Yamile Haito Chavez, Majidah Bukhari, Richard Nollan, Mohammad Kashif Ismail, Manabu Onimaru, Valerio Balassone, Ahmed Sharata, Lee Swanstrom, Haruhiro Inoue, Alessandro Repici, Mouen A Khashab
BACKGROUND AND AIMS: Spastic esophageal disorders (SEDs) include spastic achalasia (type III), diffuse esophageal spasm (DES), and nutcracker/jackhammer esophagus (JH). Per-oral endoscopic myotomy (POEM) has demonstrated efficacy and safety in the treatment of achalasia. Recently, POEM has been indicated for the treatment of SEDs. We conducted a systematic review and meta-analysis to determine the clinical success and safety of POEM in SEDs. METHODS: We searched several databases from 01/01/2007 to 01/10/2016 to identify studies (with five or more patients) on POEM for the treatment of SEDs...
January 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27818585/update-on-the-endoscopic-treatments-for-achalasia
#10
REVIEW
Dushant S Uppal, Andrew Y Wang
Achalasia is the most common primary motility disorder of the esophagus and presents as dysphagia to solids and liquids. It is characterized by impaired deglutitive relaxation of the lower esophageal sphincter. High-resolution manometry allows for definitive diagnosis and classification of achalasia, with type II being the most responsive to therapy. Since no cure for achalasia exists, early diagnosis and treatment of the disease is critical to prevent end-stage disease. The central tenant of diagnosis is to first rule out mechanical obstruction due to stricture or malignancy, which is often accomplished by endoscopic and fluoroscopic examination...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27803774/same-site-submucosal-tunneling-for-a-repeat-per-oral-endoscopic-myotomy-a-safe-and-feasible-option
#11
Antonios N Wehbeh, Parit Mekaroonkamol, Qiang Cai
Per oral endoscopic myotomy (POEM) is a novel endoscopic procedure for achalasia treatment. Due to its novelty and high success rates, a repeat procedure is usually not warranted, making the feasibility and safety of such approach unknown. We report the first case of a successful repeat POEM done at the same site of a previously uncompleted POEM. An 84-year-old female with type 2 achalasia presented for a POEM procedure. The procedure was aborted at the end of tunneling and before myotomy due to hypotension, which later resolved spontaneously...
October 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27756611/a-multicenter-international-registry-of-redo-per-oral-endoscopic-myotomy-poem-after-failed-poem
#12
Amy Tyberg, Stefan Seewald, Reem Z Sharaiha, Guadalupe Martinez, Amit P Desai, Nikhil A Kumta, Arnon Lambroza, Amrita Sethi, Kevin M Reavis, Ketisha DeRoche, Monica Gaidhane, Michael Talbot, Payal Saxena, Felipe Zamarripa, Maximilien Barret, Nicholas Eleftheriadis, Valerio Balassone, Haruhiro Inoue, Michel Kahaleh
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) has become an accepted treatment for patients with achalasia. Despite its excellent efficacy rate of greater than 80%, a small percentage of patients remain symptomatic after the procedure. Limited data exist as to the best management for recurrence of symptoms after POEM. We present the first international, multicenter experience on the efficacy and safety of a repeat POEM in the management of achalasia. METHODS: Patients who underwent a redo POEM from 15 centers in 9 countries were included in a dedicated registry...
October 15, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27754816/achalasia-2016-treatment-alternatives
#13
Fernando A M Herbella, Eduardo G H Moura, Marco G Patti
The treatment for achalasia changed dramatically after the introduction of minimally invasive surgery. Since 1991, laparoscopic Heller myotomy (LHM) has replaced pneumatic dilatation (PD) as the primary form of treatment in many centers. Over time, PD became safer, and eventually endoscopic experts were able to perform an endoscopic myotomy via a per oral endoscopic myotomy (POEM). This article reviews the advantages and disadvantages of each technique. Ultimately, the best outcomes are obtained by a multidisciplinary team that can tailor a specific treatment to each individual patient...
January 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27663714/long-term-outcomes-of-per-oral-endoscopic-myotomy-in-patients-with-achalasia-with-a-minimum-follow-up-of-2-years-an%C3%A2-international-multicenter-study
#14
Saowanee Ngamruengphong, Haruhiro Inoue, Philip Wai-Yan Chiu, Hon Chi Yip, Amol Bapaye, Michael Ujiki, Lava Patel, Pankaj N Desai, Bu Hayee, Amyn Haji, Vivien Wai-Yin Wong, Silvana Perretta, Shivangi Dorwat, Mathieu Pioche, Sabine Roman, Jérôme Rivory, François Mion, Thierry Ponchon, Aurélien Garros, Jun Nakamura, Yoshitaka Hata, Valerio Balassone, Manabu Onimaru, Gulara Hajiyeva, Amr Ismail, Yen-I Chen, Majidah Bukhari, Yamile Haito-Chavez, Vivek Kumbhari, Roberta Maselli, Alessandro Repici, Mouen A Khashab
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) has shown promising safety and efficacy in short-term studies. However, long-term follow-up data are very limited. The aims of this study were to assess (1) clinical outcome of patients with a minimum post-POEM follow-up of 2 years and (2) factors associated with long-term clinical failure after POEM. METHODS: A retrospective chart review was performed that included all consecutive patients with achalasia who underwent POEM with a minimum follow-up of 2 years at 10 tertiary-care centers...
September 20, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27609778/early-adverse-events-of-per-oral-endoscopic-myotomy
#15
Yuki B Werner, Daniel von Renteln, Tania Noder, Guido Schachschal, Ulrike W Denzer, Stefan Groth, Jan F Nast, Jan F Kersten, Martin Petzoldt, Gerhard Adam, Oliver Mann, Alessandro Repici, Cesare Hassan, Thomas Rösch
BACKGROUND AND AIMS: The recently developed technique of per-oral endoscopic myotomy (POEM) has been shown to be effective for the therapy of esophageal motility disorders. Limited information is available about POEM adverse events (AEs). METHODS: POEM was performed on 241 patients (58% male; mean age, 47.4 ± 16.4 years) under general anesthesia over 61 months. The main outcome was the rate of intra- and post-procedural AEs. Post-procedural checks comprised clinical and laboratory examinations and endoscopy, with further follow-ups performed at 3, 6, and 12 months...
September 5, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27571581/achalasia-from-diagnosis-to-management
#16
Michael F Vaezi, Valter N Felix, Roberto Penagini, Aurelio Mauro, Eduardo Guimarães Hourneaux de Moura, Leonardo Zorrón Cheng Tao Pu, Jan Martinek, Erwin Rieder
Achalasia is an esophageal motility disorder associated with abnormalities in peristalsis and lower esophageal sphincter (LES) relaxation. The etiology of the disease remains elusive. It is often misdiagnosed initially as gastroesophageal reflux disease. Patients with achalasia often complain of dysphagia to solids and liquids but may focus on regurgitation as the primary symptom, leading to the early misdiagnosis. Chest pain, weight loss, and occasional vomiting may be additional symptoms encountered in those with achalasia...
August 29, 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27568151/the-state-of-the-art-in-per-oral-endoscopic-myotomy
#17
Stavros N Stavropoulos, Rani Modayil, David Friedel
Per-oral endoscopic myotomy has emerged as the preferred option for treatment of achalasia. This entirely endoscopic procedure has clinical efficacy and lower esophageal sphincter disruption comparable to laparoscopic Heller myotomy with lesser postprocedure pain and length of stay. This review describes per-oral endoscopic myotomy technique, evolution, patient selection, comparison to other therapies, training, and future considerations, including extrapolation of tunnel endoscopy to other situations.
2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27553792/impact-of-prior-interventions-on-outcomes-during-per-oral-endoscopic-myotomy
#18
Brian E Louie, Andreas M Schneider, Drew B Schembre, Ralph W Aye
BACKGROUND: Per oral endoscopic myotomy (POEM) is performed by accessing the submucosal space of the esophagus. This space may be impacted by prior interventions such as submucosal injections, dilations or previous myotomies. These interventions could make POEM more difficult and may deter surgeons during their initial experience. We sought to determine the impact of prior interventions on our early experience. METHODS: Prospective, single-center study of consecutive patients undergoing POEM...
August 23, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27534662/poem-is-a-cost-effective-procedure-cost-utility-analysis-of-endoscopic-and-surgical-treatment-options-in-the-management-of-achalasia
#19
Heidi J Miller, Ruel Neupane, Mojtaba Fayezizadeh, Arnab Majumder, Jeffrey M Marks
BACKGROUND: Achalasia is a rare motility disorder of the esophagus. Treatment is palliative with the goal of symptom remission and slowing the progression of the disease. Treatment options include per oral endoscopic myotomy (POEM), laparoscopic Heller myotomy (LM) and endoscopic treatments such as pneumatic dilation (PD) and botulinum toxin type A injections (BI). We evaluate the economics and cost-effectiveness of treating achalasia. METHODS: We performed cost analysis for POEM, LM, PD and BI at our institution from 2011 to 2015...
August 17, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27514392/a-matched-comparison-of-per-oral-endoscopic-myotomy-to-laparoscopic-heller-myotomy-in-the-treatment-of-achalasia
#20
Andreas M Schneider, Brian E Louie, Heather F Warren, Alexander S Farivar, Drew B Schembre, Ralph W Aye
BACKGROUND: Per oral endoscopic myotomy (POEM) is increasingly utilized to treat patients with achalasia. Early results have demonstrated significant improvement of symptoms, but there are concerns about postoperative reflux. With only limited comparative data available, we sought to compare POEM to laparoscopic Heller myotomy (LHM) with partial fundoplication. METHODS: This is a retrospective review of 42 POEM and 84 LHM patients undergoing primary myotomy for achalasia...
August 11, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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