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https://www.readbyqxmd.com/read/28919276/-focus-on-achalasia
#1
Marie-Anne Guillaumot, Maximilien Barret, Sarah Leblanc, Mahaut Leconte, Bertrand Dousset, Ammar Oudjit, Frédéric Prat, Stanislas Chaussade
The pathophysiology of achalasia is largely unknown, and involves the destruction of ganglion cell in the esophageal myenteric plexus. High-resolution esophageal manometry is the key investigation. Endoscopic pneumodilatation and laparoscopic Heller myotomy have comparable short-term success rates, around 90%. The main complication after pneumodilatation is esophageal perforation, occurring in about 1% of cases. Peroral endoscopic myotomy is a promising treatment modality, however with frequent post-procedural gastroesophageal reflux...
September 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28916889/teaching-peroral-endoscopic-myotomy-poem-to-surgeons-in-practice-an-into-the-fire-pre-post-test-curriculum
#2
Tomokazu Kishiki, Brittany Lapin, Chi Wang, Brandon Jonson, Lava Patel, Matthew Zapf, Matthew Gitelis, Maria A Cassera, Lee L Swanström, Michael B Ujiki
INTRODUCTION: With the increasing adoption of peroral endoscopic myotomy (POEM) as a first-line therapy for achalasia as well as a growing list of other indications, it is apparent that there is a need for effective training methods for both endoscopists in training and those already in practice. We present a hands-on-focused with pre- and post-testing methodology to teach these skills. METHODS: Six POEM courses were taught by 11 experienced POEM endoscopists at two independent simulation laboratories...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28898921/long-term-quality-of-life-after-peroral-endoscopic-myotomy-remains-compromised-in-patients-with-achalasia-type-iii
#3
Oscar V Hernández Mondragón, Marina A González Martinez, Juan M Blancas Valencia, Maria L Hernandez Reyes, Omar M Solórzano Pineda, Gerardo Blanco Velasco
Background and study aims Peroral endoscopic myotomy (POEM) is an excellent endoscopic treatment for achalasia. Clinical and manometric parameters are used for evaluation and follow-up. However, clinical success does not guarantee high quality of life (QoL) scores, generating doubts about their direct relationship. We aimed to evaluate QoL scores before and after POEM at medium and long term, to evaluate differences between achalasia subtypes and find which factors related to low QoL scores. Patients and methods Achalasia-confirmed patients undergoing POEM between February 2012 and November 2016...
September 12, 2017: Endoscopy
https://www.readbyqxmd.com/read/28894876/erratum-to-per-oral-endoscopic-myotomy-poem-mid-term-efficacy-and-safety
#4
Jan Martinek, Hana Svecova, Zuzana Vackova, Radek Dolezel, Ondrej Ngo, Jana Krajciova, Eva Kieslichova, Radim Janousek, Alexander Pazdro, Tomas Harustiak, Lucie Zdrhova, Pavla Loudova, Petr Stirand, Julius Spicak
The Given Names and Family Names were all inadvertently inverted. The correct order is: Jan Martinek, Hana Svecova, Zuzana Vackova, Radek Dolezel, Ondrej Ngo, Jana Krajciova, Eva Kieslichova, Radim Janousek, Alexander Pazdro, Tomas Harustiak, Lucie Zdrhova, Pavla Loudova, Petr Stirand, Julius Spicak. The original article was corrected.
September 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28884499/per-oral-endoscopic-myotomy-in-achalasia-and-large-epiphrenic-diverticulum-a-case-study
#5
Michal Demeter, Peter Bánovčin, Martin Ďuriček, Rastislav Kunda, Rudolf Hyrdel
Symptomatic epiphrenic diverticula are mostly treated surgically with laparoscopic diverticulectomy, myotomy and anterior fundoplication. However, in case the patient does not agree with surgical therapy or is contraindicated there are limited ways of alternative treatment. We present a case report of a 72-year-old female patient with severe dysphagia, regurgitation, paroxysmal cough, weight loss and malnutrition who was diagnosed with achalasia and large epiphrenic diverticulum. She did not give consent with surgical treatment that was proposed...
September 7, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28875504/zenker-s-diverticulum-submucosal-tunneling-endoscopic-septum-division-z-poem
#6
Oscar Víctor Hernandez Mondragón, Omar Michel Solórzano Pineda, Juan Manuel Blancas Valencia
BACKGROUND: Zenker diverticulum is characterized by dysphagia, weight loss and bronchoaspiration [1]. Open surgery has been the cornerstone of treatment, with good response but recurrence up to 35%.[2]. Rigid endoscopic diverticulotomy has similar results, but with conversion to open surgery up to 30%[3]. Flexible endoscopic diverticulotomy is safe, effective and can be performed in an endoscopic setting, but multiple sessions are needed because of uncomplete cut of the septum[4,5]. Z-POEM is a new procedure in which a total septum myotomy throughout a submucosal tunnel can be performed...
September 6, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28874962/usefulness-of-the-hook-knife-in-flexible-endoscopic-myotomy-for-zenker-s-diverticulum
#7
Olivier Rouquette, Armando Abergel, Aurélien Mulliez, Laurent Poincloux
AIM: To investigate the outcome of flexible endoscopic myotomy performed with the Hook knife in patients with symptomatic Zenker's diverticulum (ZD). METHODS: All consecutive patients treated for ZD at our institution between 7/2012 and 12/2016 were included. The flexible endoscopic soft diverticuloscope-assisted technique with endoclips placement and Hook knife myotomy were performed in all patients. Here we report a retrospective review of prospectively collected data...
August 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28867972/peroral-endoscopic-myotomy-for-the-management-of-esophageal-disorders
#8
Ian S Grimm
No abstract text is available yet for this article.
July 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28867969/an-overview-of-achalasia-and-its-subtypes
#9
Dhyanesh A Patel, Brian M Lappas, Michael F Vaezi
Achalasia is one of the most studied esophageal motility disorders. However, the pathophysiology and reasons that patients develop achalasia are still unclear. Patients often present with dysphagia to solids and liquids, regurgitation, and varying degrees of weight loss. There is significant latency prior to diagnosis, which can have nutritional implications. The diagnosis is suspected based on clinical history and confirmed by esophageal high-resolution manometry testing. Esophagogastroduodenoscopy is necessary to rule out potential malignancy that can mimic achalasia...
July 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28859394/esophageal-achalasia-a-risk-factor-for-carcinoma-a-systematic-review-and-meta-analysis
#10
F Tustumi, W M Bernardo, J R M da Rocha, S Szachnowicz, F C Seguro, E T Bianchi, R A A Sallum, I Cecconello
Achalasia of the cardia is associated with an increased risk of esophageal carcinoma. The real burden of achalasia at the malignancy genesis is still a controversial issue. Therefore, there are no generally accepted recommendations on follow-up evaluation for achalasia patients. This study aims to estimate the risk of esophageal adenocarcinoma and squamous cell carcinoma in achalasia patients. We searched for association between carcinoma and esophageal achalasia in databases up to January 2017 to perform a systematic review and meta-analysis...
October 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28859393/open-peroral-endoscopic-myotomy-o-poem-for-the-treatment-of-achalasia
#11
W Liu, H-Z Zeng, H-L Chen, C-C Wu, L-S Ye, B Hu
With the development of endoscopic interventions and inspired by the success of peroral endoscopic myotomy (POEM) for the treatment of achalasia, we investigated an old method of direct peroral endoscopic myotomy without a submucosal tunnel for the treatment of achalasia, which we call open peroral endoscopic myotomy (O-POEM). In this study, Clinical success was achieved in the patient after O-POEM. A reduction of LES pressure, Eckardt score, and a timed barium esophagogram were observed during follow-up. There were no severe complications and no recurrences during two months of follow-up...
October 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28846807/two-penetrating-vessels%C3%A2-as-a-novel-indicator-of-the-appropriate-distal-end-of-per-oral-endoscopic-myotomy
#12
Shinwa Tanaka, Fumiaki Kawara, Takashi Toyonaga, Haruhiro Inoue, Robert Bechara, Namiko Hoshi, Hirohumi Abe, Yoshiko Ohara, Tsukasa Ishida, Yoshinori Morita, Eiji Umegaki
OBJECTIVES: One of the challenges during per-oral endoscopic myotomy (POEM) is ensuring the appropriate length of myotomy on the gastric side. To determine the appropriate distal end of the gastric myotomy, we focused on the two penetrating vessels (TPVs) found in the gastric cardia during POEM. In this study, we evaluated whether the TPVs could serve as an accurate indicator of the appropriate distal end of the gastric myotomy. METHODS: All patients who underwent POEM between March and August 2016 were included for this study...
August 28, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28845589/gastrointestinal-peroral-endoscopic-myotomy-for-distal-esophageal-spasm
#13
X Tang, Y Ren, S Huang, X Zhang, W Gong
No abstract text is available yet for this article.
September 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28840505/anesthesia-in-per-oral-endoscopic-myotomy-a-large-tertiary-care-centre-experience
#14
Santosh Darisetty, Zaheer Nabi, Mohan Ramchandani, Radhika Chavan, Rama Kotla, D Nageshwar Reddy
BACKGROUND AND OBJECTIVES: Per-oral endoscopic myotomy (POEM) is safe and efficacious for the management of achalasia cardia (AC). POEM is usually performed under general anesthesia in an endoscopy suite or operating theatre. The current study was conducted with the aim to analyse anesthetic management of patients with AC who underwent POEM at our institution. METHODS: We retrospectively analysed the data of patients with AC who underwent POEM at our institution from January 2013 to September 2016...
August 24, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28839899/poem-and-the-management-of-achalasia
#15
Matthew Banks, Rami Sweis
Achalasia is a rare oesophageal motility disorder predominantly causing dysphagia and regurgitation of food and fluids. Diagnosis is made typically after a combination of tests including endoscopy, barium swallow and oesophageal manometry. The advent of high-resolution manometry has led to the Chicago Classification which divided achalasia into three types. This improved the understanding of presentation, prognosis and might also help tailor therapy. Botulinum toxin has been shown to have good, but short-term efficacy...
April 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28836246/-clinical-experience-of-combined-laparoscopic-endoscopic-heller-myotomy-and-modified-dor-fundoplication-for-cardiochalasia
#16
Xiaofang Qiao, Jinlong Li, Hua Xu, Xin Wan, Jiaming Zhu
OBJECTIVE: To investigate the efficacy of combined laparoscopic-endoscopic lower esophageal sphincterotomy and modified Dor fundoplication for cardiochalasia patients. METHODS: Clinical data of 11 cardiochalasia patients who underwent combined laparoscopic-endoscopic lower esophageal sphincterotomy and modified Dor fundoplication by the same medical team from January 2015 to December 2016 at The Second Hospital of Jilin University were retrospectively analyzed. The procedure was as follows: an incision was made in the anterior wall of esophagus and dissection of esophageal muscular layer was performed, then the bulged esophageal mucosa was covered by the fundus after 180 degrees fold to the right (fundoplication), finally the gastric fundus was joined to the right diaphragmatic foot by 3 to 5 knotted suture...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28832360/gastric-interventional-endoscopy
#17
Mohamed Mahmoud, Erik Holzwanger, Wahid Wassef
PURPOSE OF REVIEW: To review new advances in gastric interventional endoscopy. RECENT FINDINGS: Implementation of gastric endoscopy as a therapeutic option in obesity, gastric cancer, and gastroparesis. SUMMARY: Less invasive new gastric endoscopic procedures can potentially replace currently offered laparoscopic approaches in many fields. In this article, we will review the use of endoscopic sleeve gastroplasty as a weight loss procedure, endoscopic submucosal dissection in treatment of early gastric cancer, and gastric per-oral endoscopic myotomy in treatment of refractory gastroparesis...
August 21, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28832359/functional-dyspepsia-and-gastroparesis
#18
Jan Tack, Florencia Carbone
PURPOSE OF REVIEW: This review summarizes recent progress in the epidemiology, pathophysiology and treatment of functional dyspepsia and gastroparesis. RECENT FINDINGS: The definition of functional dyspepsia and its subgroups has been revised in the recent Rome IV consensus. In gastroparesis, the symptom pattern and its similarities and differences from functional dyspepsia have been a focus of recent research. In functional dyspepsia, pathophysiological research continued to evaluate gastric sensorimotor dysfunctions, but low-grade inflammatory changes and loss of mucosal integrity in the duodenum is a new topic of intense research...
August 21, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28827050/initial-experience-with-peroral-endoscopic-myotomy-for-treatment-of-achalasia-in-children
#19
William C Kethman, Chad M Thorson, Tiffany J Sinclair, William E Berquist, Stephanie D Chao, James K Wall
BACKGROUND: Achalasia is a primary esophageal motility disorder characterized by aperistalsis of the esophagus and failed relaxation of the lower esophageal sphincter that presents rarely in childhood. The peroral endoscopic myotomy (POEM) procedure is an emerging treatment for achalasia in adults that has recently been introduced into pediatric surgical practice. METHODS: This is a prospective case series of all children referred to Stanford University Lucile Packard Children's Hospital with manometry-confirmed achalasia who underwent a POEM procedure from 2014 to 2016...
August 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28815063/the-impact-of-flexible-endoscopy-in-esophageal-surgery
#20
REVIEW
Alejandro Nieponice, Fabio Nachman, Adolfo Badaloni, Franco Ciotola, Cecilia Zubieta, Mauricio Ramirez
Achalasia and Treatment of esophageal Adenocarcinoma are commonly associated to surgical resection. Newer technologies in interventional endoscopy gave way to a substantial paradigm shift in the management of these conditions. In the case of achalasia, endoscopic myotomy is rapidly displacing Heller's myotomy as the gold standard in many centers. Early stage neoplasia in Barrett's esophagus (BE) comprising high-grade dysplasia (HGD), intramucosal and, in some cases, submucosal carcinoma is now being treated without the need of esophagectomy...
July 2017: Journal of Thoracic Disease
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