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Endoscopic myotomy

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https://www.readbyqxmd.com/read/28426463/treatments-for-achalasia-in-2017-how-to-choose-among-them
#1
Peter J Kahrilas, John E Pandolfino
PURPOSE OF REVIEW: To review recent advances in achalasia diagnostics and therapeutics. RECENT FINDINGS: The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]...
April 19, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28417135/a-training-model-for-introducing-a-novel-surgical-procedure-into-clinical-practice-our-experience-on-peroral-endoscopic-myotomy-for-achalasia
#2
Dedrick Kh Chan, Reuben Km Wong, Janelle Ns Phua, Asim Shabbir, Khek Yu Ho, Philip Wy Chiu, Jimmy By So
No abstract text is available yet for this article.
March 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28411346/peroral-endoscopic-myotomy-compared-with-pneumatic-dilation-for-newly-diagnosed-achalasia
#3
Fandong Meng, Peng Li, Yongjun Wang, Ming Ji, Yongdong Wu, Li Yu, Yinglin Niu, Fujing Lv, Wei Li, Wenyan Li, Huihong Zhai, Shanshan Wu, Shutian Zhang
BACKGROUND: This study retrospectively compared the safety and efficacy of two endoscopic techniques for treating newly diagnosed achalasia, pneumatic dilation (PD), and peroral endoscopic myotomy (POEM). METHODS: Demographics, clinical and manometric data, and outcomes were collected from the medical records of patients who received POEM or PD as the primary therapy for achalasia at our hospital from January 2012 to August 2015. RESULTS: Of 72 patients, 32 and 40 received POEM and PD, respectively...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28393437/what-is-the-clinical-significance-of-esophagogastric-junction-outflow-obstruction-evaluation-of-60-patients-at-a-tertiary-referral-center
#4
F C Okeke, S Raja, K L Lynch, S Dhalla, M Nandwani, E M Stein, B Chander Roland, M A Khashab, P Saxena, V Kumbhari, N K Ahuja, J O Clarke
BACKGROUND: Esophagogastric junction (EGJ) outflow obstruction (EGJOO) is characterized by impaired EGJ relaxation with intact or weak peristalsis. Our aims were to evaluate: (i) prevalence, (ii) yield of fluoroscopy, endoscopy, and endoscopic ultrasound (EUS), (iii) outcomes, and (iv) whether this data differed based on quantitative EGJ relaxation. METHODS: Studies that met criteria for EGJOO were identified. Demographics, encounters, endoscopy, radiology, treatment decisions, and outcomes were extracted...
April 9, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28390804/open-vs-endoscopic-cricopharyngeal-myotomy-is-there-a-difference
#5
Colin Huntley, Maurits Boon, Joseph Spiegel
INTRODUCTION: The upper esophageal sphincter (UES) is composed largely of the cricopharyngeus muscle (CP) and acts as the gatekeeper to the esophagus. There are multiple methods of treating UES dysfunction, but myotomy has been shown to be the most definitive means. We aim to evaluate the difference between open and endoscopic CP myotomy (CPM). METHODS: A retrospective review of all patients undergoing endoscopic and open CPM was undertaken. We recorded demographic, clinical, operative, hospital, and postoperative data for both groups from January 2010-March 2015...
March 31, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28375443/long-term-outcomes-of-peroral-endoscopic-myotomy-for-patients-with-achalasia-a-retrospective-single-center-study
#6
H Guo, H Yang, X Zhang, L Wang, Y Lv, X Zou, T Ling
Peroral endoscopic myotomy (POEM) has been widely applied to the treatment of achalasia. The aim of this study is to retrospectively investigate the long-term outcome of POEM in patients with achalasia. Patients undergoing POEM at our center with a minimum follow-up of 3 years were enrolled in this study. Relief of patients' symptom was defined as the primary outcome. Secondary outcomes included lower esophageal sphincter pressure, esophageal emptying, symptoms relapse, and clinical reflux adverse events. The Chi-square test was performed to determine the potential predictors of surgical failure...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375437/achalasia-an-unnecessary-long-way-to-diagnosis
#7
S Niebisch, E Hadzijusufovic, M Mehdorn, M Müller, U Scheuermann, O Lyros, H G Schulz, B Jansen-Winkeln, H Lang, I Gockel
Although achalasia presents with typical symptoms such as dysphagia, regurgitation, weight loss, and atypical chest pain, the time until first diagnosis often takes years and is frustrating for patients and nevertheless associated with high costs for the healthcare system. A total of 563 patients were interviewed with confirmed diagnosis of achalasia regarding their symptoms leading to diagnosis along with past clinical examinations and treatments. Included were patients who had undergone their medical investigations in Germany...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28374443/the-applications-of-poem-for-special-patient-cohorts-a-review
#8
REVIEW
Dan Mu, Yue Yue Li, Ming Ming Zhang, Yan Zhang, Zhen Li, Yan Qing Li
Peroral endoscopic myotomy (POEM) is a relatively mini-invasive technique which can perform endoscopic myotomy by establishing a submucosal tunnel, and it has been firstly applied in animals since 2007.(1).
April 4, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28361839/peroral-endoscopic-myotomy-achieves-similar-clinical-response-but-incurs-lesser-charges-compared-to-robotic-heller-myotomy
#9
Mouen A Khashab, Vivek Kumbhari, Alan H Tieu, Mohamad H El Zein, Amr Ismail, Saowanee Ngamruengphong, Vikesh K Singh, Anthony N Kalloo, John O Clarke, Ellen M Stein
BACKGROUND/AIM: Several uncontrolled studies comparing peroral endoscopic myotomy (POEM) and Heller myotomy have demonstrated equivalent short-term efficacy and safety. However, no data exists rergarding the cost of POEM and how it compares to that of robotic Heller myotomy (RHM). The primary aim of this study was to compare the inpatient charges incurred in patients who underwent POEM or RHM for the treatment of achalasia. PATIENTS AND METHODS: A retrospective single center review was conducted among 52 consecutive POEM patients (2012-2014) and 52 consecutive RHM patients (2009-2014)...
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28361836/the-choice-of-myotomy-in-achalasia-cardia-heller-s-or-per-oral-endoscopic-myotomy
#10
EDITORIAL
Zaheer Nabi, Mohan Ramchandani, D Nageshwar Reddy
No abstract text is available yet for this article.
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28337484/first-reported-case-of-per-anal-endoscopic-myectomy-paem-a-novel-endoscopic-technique-for-resection-of-lesions-with-severe-fibrosis-in-the-rectum
#11
David Ozzie Rahni, Takashi Toyonaga, Yoshiko Ohara, Francesco Lombardo, Shinichi Baba, Hiroshi Takihara, Shinwa Tanaka, Fumiaki Kawara, Takeshi Azuma
Background and study aims A 54-year-old man was diagnosed with a rectal tumor extending through the submucosal layer. The patient refused surgery and therefore endoscopic submucosal dissection (ESD) was pursued. The lesion exhibited the muscle retraction sign. After dissecting circumferentially around the fibrotic area by double tunneling method, a myotomy was performed through the internal circular muscle layer, creating a plane of dissection between the internal circular muscle layer and the external longitudinal muscle layer, and a myectomy was completed...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28321165/fibrin-sealant-for-closure-of-mucosal-penetration-at-the-cardia-during-peroral-endoscopic-myotomy-a-retrospective-study-at-a-single-center
#12
Wen-Gang Zhang, En-Qiang Linghu, Hui-Kai Li
AIM: To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy (POEM). METHODS: Twenty-four patients who underwent POEM and experienced mucosal injury of the cardia during the procedure were retrospectively identified. Of the 24 patients, 21 had mucosal penetration and 3 had only slight mucosal damage without penetration. The 21 patients with mucosal penetration received fibrin sealant for closure at the site of penetration...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28317687/filling-the-gap-safety-of-per-oral-endoscopic-myotomy-attested-by-evidence
#13
EDITORIAL
Quan-Lin Li, Ping-Hong Zhou
No abstract text is available yet for this article.
April 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28316620/clinical-outcomes-and-safety-of-partial-full-thickness-myotomy-versus-circular-muscle-myotomy-in-peroral-endoscopic-myotomy-for-achalasia-patients
#14
Chenyu Li, Aixia Gong, Jingwen Zhang, Zhijun Duan, Linmei Ge, Nan Xia, Jing Leng, Mei Li, Yanjie Liu
Background. Here we aimed to evaluate and compare the efficacy and safety between partial full-thickness myotomy and circular muscle myotomy during POEM procedure in achalasia patients. Methods. Clinical data of achalasia of cardia (AC) patients who underwent POEM in our center during January 2014 to January 2015 was collected (34 cases). 19 patients who received partial full-thickness myotomy were assigned to group A and 14 patients who received circular muscle myotomy were assigned to group B. The procedure-related parameters between the two groups were compared...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28315151/peroral-endoscopic-myotomy-for-type-iii-achalasia-of-chicago-classification-outcomes-with-a-minimum-follow-up-of-24%C3%A2-months
#15
Wengang Zhang, En-Qiang Linghu
INTRODUCTION: There are only few studies about the outcomes of peroral endoscopic myotomy (POEM) for type III achalasia in a relatively large population to date. The purpose of this study was to explore the long-term efficacy of POEM for patients with type III achalasia. METHODS: There were a total of 32 consecutive patients with type III achalasia undergoing POEM in our hospital from July 2012 to October 2014. Clinical date of general characteristics, procedure-related parameters and adverse events, symptom relief, and the high-resolution manometry outcomes before and during the periodic follow-up were retrospectively collected and analyzed...
March 17, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28260955/peroral-endoscopic-myotomy-procedural-complications-and-pain-management-for-the-perioperative-clinician
#16
Lopa Misra, Norio Fukami, Katarina Nikolic, Terrence L Trentman
Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM) in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28250904/combination-of-concurrent-endoscopic-submucosal-dissection-and-modified-peroral-endoscopic-myotomy-for-an-achalasia-patient-with-synchronous-early-esophageal-neoplasms
#17
Sha Shi, Kuangi Fu, Xin-Qian Dong, Yu-Jing Hao, Sen-Lin Li
Achalasia is generally accepted as a condition associated with an increased risk for developing esophageal squamous cell carcinoma. In our paper, we introduced an achalasia patient combined with synchronous early esophageal neoplasms. We performed a combination of concurrent endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM). No complications other than postoperative pain that needed morphine treatment for two days had occurred. Dysphagia was significantly improved. Neither reflux nor cough occurred...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28243108/successful-peroral-endoscopic-myotomy-performed-in-endoscopy-department-as-a-radical-long-term-treatment-for-esophageal-achalasia-the-greek-experience
#18
Nikolas Eleftheriadis, Eleni Damianos Eleftheriadou
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been considered as a minimal-invasive, innovative technique for long-term treatment of all types of esophageal achalasia and other esophageal motility disorders. PATIENTS AND METHODS: We report on 20 consecutive Greek patients with manometrically proved esophageal achalasia (14 patients with type I, 4 with type II, 2 with type III, and 4 with sigmoid esophagus), with an age range of 32-92 years, mean age 59 years, 12 males, successfully treated by POEM from 2013 to 2015...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28236012/application-of-a-computer-assisted-flexible-endoscope-system-for-transoral-surgery-of-the-hypopharynx-and-upper-esophagus
#19
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%C3%A2-efficacy-and-safety-of-per-oral-endoscopic-myotomy%C3%A2-in%C3%A2-octogenarians
#20
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 because it is minimally invasive. However, data in patients aged ≥80 years are scarce. The aim of this study was to assess the clinical outcome of POEM in octogenarians. METHODS: This was a 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 (severity graded as per American Society for Gastrointestinal Endoscopy lexicon) were assessed...
February 21, 2017: Gastrointestinal Endoscopy
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