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Endoscopic myotomy

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https://www.readbyqxmd.com/read/29780600/fluoroscopic-gastric-peroral-endoscopic-pyloromyotomy-g-poem-in-patients-with-a-failed-gastric-electrical-stimulator
#1
Abhinav Koul, Sunil Dacha, Parit Mekaroonkamol, Xiaoyu Li, Lianyong Li, Nikrad Shahnavaz, Steven Keilin, Field F Willingham, Jennifer Christie, Qiang Cai
Background: Gastric electrical stimulators (GESs) have been used to treat refractory gastroparesis in patients who fail initial therapies such as dietary modifications, control of psychological stressors and pharmacologic treatment. More recently, gastric peroral endoscopic pyloromyotomy (G-POEM) has emerged as a novel endoscopic technique to treat refractory gastroparesis. We present a case series of patients with refractory gastroparesis who failed treatment with an implanted GES that were safely treated with G-POEM performed under fluoroscopy as a salvage therapy...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29768079/the-spectrum-of-surgical-remediation-of-transoral-incisionless-fundoplication-related-failures
#2
Ruchir Puri, C Daniel Smith, Steven P Bowers
AIM: To evaluate outcomes of surgical remediation for symptomatic or anatomic failure after a transoral incisionless fundoplication (TIF). METHODS: This retrospective study was performed on 11 patients who underwent a remedial operation following TIF failure between June 2011 and September 2016 at the Mayo Clinic in Florida for persistent foregut symptoms. Upper gastrointestinal workup characterized 1 patient as having normal post-TIF anatomy and 10 as having anatomic failure...
May 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29759157/per-oral-endoscopic-myotomy-short-term-outcomes-are-good-but-the-long-term-results-are-what-count
#3
EDITORIAL
Joel E Richter
No abstract text is available yet for this article.
June 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29756656/pathophysiology-and-treatment-of-achalasia-in-a-muscle-mechanical-perspective
#4
REVIEW
Hans Gregersen, Kar Man Lo
This review provides a biomechanical perspective on the pathophysiology and treatment of achalasia. The esophagus is efficient in transporting ingested material to the stomach in healthy subjects. A fine balance exists between the peristaltic forces generated in the esophageal body (which herein is defined as the preload) and the resistance in the outlet, the esophago-gastric junction (which is defined as the afterload). Achalasia is a rare esophageal disease that progressively over many years challenges esophageal efficacy...
May 14, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29756011/transoral-incisional-fundoplication-for-reflux-after-peroral-endoscopic-myotomy-a-crucial-addition-to-our-arsenal
#5
Amy Tyberg, Anthony Choi, Monica Gaidhane, Michel Kahaleh
Introduction:  Increased esophageal acid exposure is seen in a large percentage of patients with achalasia who undergo peroral endoscopic myotomy (POEM). Endoscopic transoral fundoplication (TIF) is a novel endoscopic technique for the management of patients with chronic gastroesophageal reflux (GERD). We present the first case series evaluating the role of TIF post-POEM. Methods:  Consecutive patients 18 years or older from our academic institution who underwent a POEM procedure and subsequently underwent TIF for symptomatic reflux or regurgitation between December 2014 and June 2017 were included...
May 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29748143/the-investigation-and-treatment-of-diabetic-gastroparesis
#6
REVIEW
Mohit Kumar, Adam Chapman, Saad Javed, Uazman Alam, Rayaz A Malik, Shazli Azmi
PURPOSE: This review provides an update on the investigations and treatment options for gastroparesis. METHODS: A comprehensive literature search of Medline, PubMed, Embase and OVID was conducted which included all systematic reviews and research articles that focused on the diagnosis, investigations and management diabetic gastroparesis. FINDINGS: Dietary modifications and pharmacologic treatment with prokinetics to increase gastric motility form the mainstay of treatment...
May 7, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29742979/electrical-stimulation-of-the-lower-esophageal-sphincter-to-treat-gastroesophageal-reflux-after-poem
#7
Erwin Rieder, Matthias Paireder, Ivan Kristo, Katrin Schwameis, Sebastian F Schoppmann
As per-oral endoscopic myotomy (POEM) is not followed by any anti-reflux procedure, a common concern is the risk of postoperative gastro-esophageal reflux disease (GERD). Electrical stimulation of the lower esophageal sphincter (LES-EST) could be an option for post-POEM GERD. A 68-year old male obese patient underwent successful POEM but developed GERD not responsive to proton pump inhibitors. Consecutively, the patient had implanted an electrical LES stimulation device, consisting of bipolar LES-electrodes connected to a subcutaneous pulse generator...
May 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29742777/peroral-endoscopic-dual-myotomy-dual-poem-for-achalasia-with-severe-esophageal-dilatation
#8
Xiang-Lei Yuan, Wei Liu, Lian-Song Ye, Ping Yan, Yu Wang, Naveed Khan, Bing Hu
No abstract text is available yet for this article.
May 9, 2018: Endoscopy
https://www.readbyqxmd.com/read/29742769/peroral-endoscopic-myotomy-as-a-versatile-approach-to-treating-complex-esophageal-disorders
#9
Antonella Putignano, Marc Barthet, Ricardo Rio-Tinto, Guido Costamagna, Hubert Louis, Vincent Huberty, Arnaud Lemmers, Jacques Devière
No abstract text is available yet for this article.
May 9, 2018: Endoscopy
https://www.readbyqxmd.com/read/29733017/zenker-diverticulum-treatment-endoscopic-or-surgical
#10
Diana Ciuc, Rodica Birlă, Eugenia Panaitescu, Marcel Tanţău, Silviu Constantinoiu
Introduction: The Zenker Diverticulum is a rare pathology, the selection of patients for invasive treatments is questionable, as well as the applied therapeutic method. The aim of the study is to evaluate the main methods of classical and endoscopic surgical treatment in this pathology and to correlate pathophysiological aspects with clinical consequences. MATERIAL AND METHOD: We included 36 patients with Zenker hypopharyngeal diverticulum treated in 2010/2017 in two university clinics: 7 patients by classical surgical approach at the General and Esophageal Surgery Clinic of St...
March 2018: Chirurgia
https://www.readbyqxmd.com/read/29733014/peroral-endoscopic-myotomy-versus-heller-myotomy-for-achalasia-pros-and-cons
#11
Cristian Tefas, Rami Ababneh, Marcel Tanţău
Achalasia is an esophageal motor disorder that has multiple endoscopic and surgical methods of treatment. However, there is no consensus on optimal therapy in patients suffering from this disorder. This review discusses two therapies with similar but technically different concepts, peroral endoscopic myotomy and Heller surgical myotomy. After a brief introduction to the basic problems of achalasia, technical considerations, intra and postprocedural complications are presented and the advantages and disadvantages of the two procedures are discussed, based on the relevant articles in the literature...
March 2018: Chirurgia
https://www.readbyqxmd.com/read/29712597/esophageal-resection-for-end-stage-achalasia
#12
REVIEW
Alberto Aiolfi, Emanuele Asti, Gianluca Bonitta, Stefano Siboni, Luigi Bonavina
Achalasia is a rare disease characterized by impaired lower esophageal sphincter relaxation loss and of peristalsis in the esophageal body. Endoscopic balloon dilation and laparoscopic surgical myotomy have been established as initial treatment modalities. Indications and outcomes of esophagectomy in the management of end-stage achalasia are less defined. A literature search was conducted to identify all reports on esophagectomy for end-stage achalasia between 1987 and 2017. MEDLINE, Embase, and Cochrane databases were consulted matching the terms "achalasia," "end-stage achalasia," "esophagectomy," and "esophageal resection...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712596/the-treatment-of-achalasia-in-obese-patients
#13
REVIEW
Julie A Wesp, Timothy M Farrell
Epidemiological studies have demonstrated that obesity is frequently associated with esophageal motility disorders. Morbid obesity and achalasia may coexist in the same patient. The management of the morbidly obese patient with achalasia is complex and the most effective treatment remains controversial. The aim of this study is to review the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of achalasia in morbidly obese patients. EVIDENCE REVIEW: PubMed search from January 1990 to July 2017, including the following terms: achalasia, morbid obesity, bariatric, and treatment...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712595/laparoscopic-heller-myotomy-versus-per-oral-endoscopic-myotomy-evidence-based-approach-to-the-treatment-of-esophageal-achalasia
#14
Francisco Schlottmann, Marco G Patti
Esophageal achalasia is a rare disorder characterized by a failure of the lower esophageal sphincter to relax during swallowing, combined with aperistalsis of the esophageal body. Treatment is not curative, but aims to eliminate the outflow resistance caused by the nonrelaxing lower esophageal sphincter. Current evidence suggests that both laparoscopic Heller myotomy and per oral endoscopic myotomy (POEM) are very effective in the relief of symptoms in patients with achalasia. Specifically, for type III achalasia, POEM may achieve higher success rates...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712594/poem-for-achalasia
#15
Daniel A Kroch, Ian S Grimm
In 2008, a new treatment modality for esophageal achalasia was introduced-peroral endoscopic myotomy (POEM). POEM is a procedure performed endoscopically, which allows transection of the muscular fibers of the distal esophagus and of the lower esophageal sphincter. The procedure is therefore similar to a laparoscopic Heller myotomy without a fundoplication. Short-term studies have shown that POEM is very effective in relieving dysphagia and regurgitation, but concerns have been raised about the incidence of post-POEM gastroesophageal reflux...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712591/endoscopic-pneumatic-dilation-for-esophageal-achalasia
#16
Sheraz Markar, Giovanni Zaninotto
Pneumatic dilation is a well-established treatment modality that has withstood the test of time. Prospective and randomized trials have shown that in expert hands, it provides results similar to a laparoscopic Heller myotomy with fundoplication. In addition, it should be considered the primary form of treatment in patients who experience recurrence of symptoms after a surgical myotomy.
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29687294/endoscopic-therapies-for-gastroparesis
#17
REVIEW
Andrew Su, Jeffrey L Conklin, Alireza Sedarat
PURPOSE OF REVIEW: Gastroparesis remains a difficult-to-treat disease with limited therapeutic options. Though patients often have a common syndrome of stereotypic symptoms, the underlying pathophysiology is heterogeneous, often leading to variable treatment responses. Due to limitations in medical and surgical therapies, endoscopic options have been increasingly explored. These options can be broadly categorized into pyloric-directed therapy, non-pyloric-directed therapy, and nutritional support...
April 23, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29684386/valuing-innovative-endoscopic-techniques-per-oral-endoscopic-myotomy-for-the-management-of-achalasia
#18
Eric D Shah, Andrew C Chang, Ryan Law
BACKGROUND AND AIMS: Unclear reimbursement for new and innovative endoscopic procedures can limit adoption in clinical practice despite effectiveness in clinical trials. The aim of this study was to determine maximum cost-effective reimbursement for per-oral endoscopic myotomy (POEM) in treating achalasia. METHODS: We constructed a decision analytic model assessing POEM versus laparoscopic Heller myotomy with Dor fundoplication (LHM) in managing achalasia from a payer perspective over a 1-year time horizon...
April 20, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29674757/ten-initial-cases-of-peroral-endoscopic-myotomy-for-treatment-of-esophageal-motility-disorders-at-okayama-university-hospital
#19
Yuusaku Sugihara, Keita Harada, Ryo Kato, Kenji Yamauchi, Shiho Takashima, Daisuke Takei, Yasushi Yamasaki, Toshihiro Inokuchi, Masahiro Takahara, Sakiko Hiraoka, Hiroyuki Okada
Peroral endoscopic myotomy (POEM) for treatment of esophageal motility disorders has recently been reported to be highly effective and less invasive than other treatment. POEM was recently introduced in Okayama University Hospital under the supervision of a physician from a high-volume center. To verify the safety and efficacy of POEM during its introduction in our institution. We examined 10 cases in whom POEM was performed between January 2016 and April 2017. The patients included 7 men and 3 women, with a median age (range) of 49 years (17-74) and median symptom duration of 6 years (1-21)...
April 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29672471/activated-eosinophils-are-present-in-esophageal-muscle-in-patients-with-achalasia-of-the-esophagus
#20
Hong Jin, Bin Wang, Li-Li Zhang, Wei Zhao
BACKGROUND The aim of this study was to undertake a histological evaluation of the presence of eosinophils in esophageal muscle in patients with achalasia before treatment with peroral endoscopic myotomy (POEM), with clinical follow-up at one year. MATERIAL AND METHODS Before treatment, esophageal biopsies including mucosa and esophageal muscle were obtained from 28 patients with achalasia. Nine patients who had undergone esophagectomy for esophageal carcinoma were included in the control group. The Eckardt Score was used to evaluate the clinical symptoms of achalasia...
April 19, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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