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Endoscopic myotomy

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https://www.readbyqxmd.com/read/28236012/application-of-a-computer-assisted-flexible-endoscope-system-for-transoral-surgery-of-the-hypopharynx-and-upper-esophagus
#1
Daniel T Friedrich, M O Scheithauer, J Greve, N Rotter, J Doescher, T K Hoffmann, P J Schuler
Zenker's diverticulum is a common pathology in the transition zone of the posterior hypopharynx and esophagus. Surgical treatment is routinely performed by ENT and general surgeons. Besides the traditional open transcervical diverticulectomy, the introduction of transoral rigid treatment led to a paradigm change and is now the preferred treatment option for patients who are fit for general anesthesia. The implementation of interventional flexible endoscopy has opened another new micro-invasive approach for patients with high morbidity...
February 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28235595/an-international-multicenter-study-evaluating-the-clinical-efficacy-and-safety-of-per-oral-endoscopic-myotomy-in-octogenarians
#2
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/28223738/peroral-endoscopic-myotomy-for-treatment-of-guillain-barre-syndrome-associated-achalasia-a-rare-case
#3
Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park
Guillain-Barre syndrome (GBS)-associated achalasia is a very rare disease of uncertain cause. We report the case of a patient diagnosed with GBS-associated type I achalasia who was successfully treated with peroral endoscopic myotomy (POEM). A 30-year-old man who was diagnosed with GBS 3 mo before was referred to our department with dysphagia and meal-related regurgitation. The results of esophagography, endoscopy, and high-resolution manometry (HRM) revealed type I achalasia. POEM that utilized a submucosal tunneling technique was performed to treat the GBS-associated type I achalasia...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28213067/duodenal-gangliocytic-paraganglioma-successfully-treated-by-local-surgical-excision-a-case-report
#4
Dimetrios Papaconstantinou, Nikolaos Machairas, Vasileia Damaskou, Nikolaos Zavras, Christine Kontopoulou, Anastasios Machairas
INTRODUCTION: Duodenal gangliocytic paragangliomas are rare neoplasms often arising in proximity to the major duodenal papilla of Vater. These neoplasms are considered to have a benign behavior with lymph node metastases being a rare phenomenon and distant metastatic disease even more so. Resection of the tumor is the only definitive therapy. PRESENTATION OF CASE: A 67year old male presented to a referring hospital with symptoms of fatigue and malaise. Evaluation with CT imaging revealed a 3...
January 19, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28188367/current-status-of-achalasia-management-a-review-on-diagnosis-and-treatment
#5
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
#6
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
#7
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/28148574/peroral-endoscopic-myotomy-a-literature-review-and-the-first-uk-case-series
#8
Shraddha Gulati, Andrew Emmanuel, Haruhiro Inoue, Bu'Hussain Hayee, Amyn Haji
Peroral endoscopic myotomy (POEM) is an established treatment for primary achalasia. It has gained endorsement from the American Society for Gastrointestinal Endoscopy with increasing clinical acceptance since the first procedure, performed in Japan in 2008. The first successful POEM in the UK was performed in November 2013 at King's College Hospital and this article presents the first UK case series. Prospective data were collected at 3 and 12-24 months for consecutive patients undergoing POEM. Post-POEM gastro-oesophageal reflux health-related quality of life scale (GORD-HRQoL) score was recorded...
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28145968/outcome-of-peroral-endoscopic-myotomy-poem-for-treating-achalasia-compared-with-laparoscopic-heller-myotomy-lhm
#9
Lijun Peng, Shuni Tian, Chao Du, Ziying Yuan, Mingxiao Guo, Lin Lu
OBJECTIVE: Peroral endoscopic myotomy (POEM) is an emerging endoscopic treatment for achalasia and the long-term efficacy of POEM remains to be evaluated. This study compared the outcomes of POEM with that of the standard laparoscopic Heller myotomy (LHM) for achalasia. MATERIALS AND METHODS: Achalasia patients treated by POEM or LHM were retrospectively analyzed, with a minimum postoperative follow-up of 3 years. Perioperative outcomes and long-term outcomes including treatment success (Eckardt score ≤3), occurrence of gastroesophageal reflux disease (GERD) (GerdQ score ≥9) and quality of life (36-item short form) were compared...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28120018/-surgical-treatment-of-achalasia-endoscopic-or-laparoscopic-proposal-for-a%C3%A2-tailored-approach
#10
B H A von Rahden, J Filser, M Al-Nasser, C-T Germer
Primary idiopathic achalasia is the most common form of the rare esophageal motility disorders. A curative therapy which restores the normal motility does not exist; however, the therapeutic principle of cardiomyotomy according to Ernst Heller leads to excellent symptom control in the majority of cases. The established standard approach is Heller myotomy through the laparoscopic route (LHM), combined with Dor anterior fundoplication for reflux prophylaxis/therapy. At least four meta-analyses of randomized controlled trials (RCTs) have demonstrated superiority of LHM over pneumatic dilation (PD); therefore, LHM should be used as first line therapy (without prior PD) in all operable patients...
January 24, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28116675/anesthetic-considerations-for-patients-with-esophageal-achalasia-undergoing-peroral-endoscopic-myotomy-a-retrospective-case-series-review
#11
Benjamin Löser, Yuki B Werner, Mark A Punke, Bernd Saugel, Sebastian Haas, Daniel A Reuter, Oliver Mann, Anna Duprée, Guido Schachschal, Thomas Rösch, Martin Petzoldt
PURPOSE: Peroral endoscopic myotomy (POEM) is a novel technique for treating esophageal achalasia. During POEM, carbon dioxide (CO2) is insufflated to aid surgical dissection, but it may inadvertently track into surrounding tissues, causing systemic CO2 uptake and tension capnoperitoneum. This in turn may affect cardiorespiratory function. This study quantified these cardiorespiratory effects and treatment by hyperventilation and percutaneous abdominal needle decompression (PND). METHODS: One hundred and seventy-three consecutive patients who underwent POEM were included in this four-year retrospective study...
January 23, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28114155/capnoperitoneum-during-peroral-endoscopic-myotomy-recognition-and-management-a-case-report
#12
Eric Lee, Jay B Brodsky, Homero Rivas, Karl Zheng, John G Brock-Utne
Peroral endoscopic myotomy (POEM) is a minimally invasive procedure for treating esophageal achalasia. During POEM, carbon dioxide is insufflated under pressure into the esophagus and stomach, which can cause clinically significant capnoperitoneum, capnomediastinum, or capnothorax. We present a case in which gas accumulation in the abdomen during POEM had adverse effects on ventilation. Once the cause was recognized, needle decompression of the abdomen led to immediate improvement in ventilation.
January 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28099056/multidisciplinary-approach-to-esophageal-achalasia-a-single-center-experience
#13
Francisco Schlottmann, Ciro Andolfi, Robert T Kavitt, Vani J A Konda, Marco G Patti
BACKGROUND: The treatment of achalasia is palliative. Pneumatic dilatation (PD) or laparoscopic Heller myotomy (LHM) just eliminates the outflow obstruction allowing easier emptying of the esophagus. The aim of this study was to evaluate the results of a multidisciplinary approach to esophageal achalasia. MATERIALS AND METHODS: A consecutive series of patients with achalasia treated by a multidisciplinary esophageal team consisting of radiologists, gastroenterologists, and surgeons in a quaternary care center between May 2008 and April 2015 were analyzed...
January 18, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28054111/-surgical-treatment-of-esophageal-diverticula-endoscopic-or-open-approach
#14
H Feußner, N Hüser, D Wilhelm, A Fingerle, A Jell, H Friess, M Bajbouj
Esophageal diverticula are comparatively rare. The majority are Zenker's diverticula but parabronchial and epiphrenic diverticula can also occur. Parabronchial diverticula are of low clinical relevance, whereas Zenker's and epiphrenic diverticula both belong to the group of pulsion diverticula and can become clinically apparent by dysphagia and regurgitation. Approximately 100 years after the first surgical treatment, peroral approaches (e.g. stapler dissection and flexible endoscopic diverticulotomy) have now achieved a certain level of importance...
January 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28052278/diagnosis-and-treatment-strategy-of-achalasia-subtypes-and-esophagogastric-junction-outflow-obstruction-based-on-high-resolution-manometry
#15
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/28011013/health-related-quality-of-life-after-laparoscopic-heller-myotomy-and-dor-fundoplication-for-achalasia
#16
Emanuele Asti, Andrea Sironi, Andrea Lovece, Giulia Bonavina, Melania Fanelli, Gianluca Bonitta, Luigi Bonavina
BACKGROUND: In addition to symptom scores, a person's perception of health and quality of life assessment is an important indicator of quality of treatment and can provide an efficient index to compare different therapeutic modalities in chronic disease states. Only a few studies have investigated quality of life comprehensively in patients with achalasia, and therefore the controversy regarding the best treatment algorithm continues. The primary study outcome was pre- and postoperative quality of life in patients with achalasia undergoing laparoscopic Heller myotomy and Dor fundoplication...
December 20, 2016: Surgery
https://www.readbyqxmd.com/read/27967203/peroral-endoscopic-myotomy-for-an-achalasia-patient-with-multiple-esophageal-diverticula
#17
Yuyong Tan, Hongyi Zhu, Deliang Liu
Peoral endoscopic myotomy (POEM) has been proved to be safe and effective for treating achalasia, however the presence of esophageal diverticulum would increase the technical difficulty. In this letter, we firstly report a case regarding POEM for achalasia with concomitant multiple esophageal diverticulums.
January 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27938463/effectiveness-of-endoscopic-cricopharyngeal-myotomy-in-adults-with-neurological-disease-systematic-review
#18
REVIEW
Ó Gilheaney, P Kerr, S Béchet, M Walshe
OBJECTIVE: To determine the effectiveness of endoscopic cricopharyngeal myotomy on upper oesophageal sphincter dysfunction in adults with upper oesophageal sphincter dysfunction and neurological disease. DATA SOURCES: Published and unpublished studies with a quasi-experimental design investigating endoscopic cricopharyngeal myotomy effects on upper oesophageal sphincter dysfunction in humans were considered eligible. Electronic databases, grey literature and reference lists of included studies were systematically searched...
December 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27931636/complications-of-submucosal-endoscopy
#19
REVIEW
Jean-Michel Gonzalez, Alban Benezech, Marc Barthet
Submucosal endoscopy essentially regroups peroral endoscopic esophageal myotomy (POEM) and, more recently, pyloromyotomy and tunnel tumor resections. The complication rate of POEM is between 5% and 10%. Complications include gas-related complications, mucosal tears, and bleeding, and are usually managed conservatively or with non-surgical procedures. Only one case of death has been reported. The most commonly identified risk factors for complicated procedures in POEM are short experience with the technique and sigmoid-type esophagus...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27928603/-laparoscopic-heller-myotomy-after-failed-poem-and-multiple-balloon-dilatations-better-late-than-never
#20
L Giulini, A Dubecz, H J Stein
BACKGROUND: Despite the lack of long-term results, peroral endoscopic myotomy (POEM) has been increasingly propagated as a feasible alternative to pneumatic balloon dilatation (BD) and laparoscopic Heller myotomy (LHM) in patients with achalasia. After a long-term follow-up, a large percentage of patients reported recurrence of dysphagia. It is unclear which kind of procedure (redo POEM or LHM) should be utilized in these patients with failed POEM. CASE REPORT AND RESULTS: We report the case of a 37-year-old female patient with type I achalasia who was successfully treated with LHM after a failed POEM procedure...
December 7, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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