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Esophageal myotomy

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https://www.readbyqxmd.com/read/28639039/a-novel-endoscopic-surgery-for-dysphagia-after-stroke
#1
Jian Wang, Wuyi Li, Yongjin Li, Xiaofeng Jin, Yanyan Niu, Xu Tian, Hong Huo
BACKGROUND: Dysphagia is a common complication in stroke patients, which severely affects quality of life. This study aimed to evaluate the effectiveness and safety of temperature-controlled plasma radiofrequency (coblation)-assisted endoscopic cricopharyngeal myotomy (CAECPM) for the treatment sustained (>6 months) dysphagia in stroke patients. METHODS: This retrospective case-control study included a total of 24 stroke patients with sustained dysphagia, who were either treated with transcervical cricopharyngeal myotomy (CPM) (n = 16) or CAECPM (n = 12)...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28617890/peroral-endoscopic-myotomy-for-the-treatment-of-achalasia-in-a-patient-with-esophageal-varices-a-case-report
#2
Naning Shen, Xin Wang, Xiaoyin Zhang, Liping Yao, Huahong Xie, Hongbo Zhang
Achalasia is very uncommon, and rarely does achalasia co-exist with esophageal varices. We present a 62-year-old woman who was diagnosed with both achalasia and esophageal varices in December 2014 and had a past history of hematemesis. The patient's achalasia symptoms' Eckardt score was 9, and her hepatic function was Child-Pugh grade A6. After comprehensive assessment of the patient's health and discussion of the pros and cons of various therapies for achalasia, the patient underwent a peroral endoscopic myotomy...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28617027/efficacy-of-peroral-endoscopic-myotomy-compared-with-other-invasive-treatment-options-for-the-different-esophageal-motor-disorders
#3
Fermín Estremera-Arévalo, Eduardo Albéniz, María Rullán, Irene Areste, Rosa Iglesias, Juan José Vila
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been performed since 2008 on more than 5,000 patients. It has proven to be highly effective in the treatment of achalasia and has shown promising outcomes for other esophageal motility spastic disorders. METHODS: A literature review of the efficacy of POEM compared to the previous invasive treatments for different esophageal motility disorders was performed. The application in the pediatric and elderly populations and its role as a rescue therapy after other procedures are also outlined...
June 15, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28616407/peroral-endoscopic-myotomy-poem-for-treating-esophageal-motility-disorders
#4
REVIEW
Ian Wong, Simon Law
Pneumatic dilatation and Heller myotomy have been thoroughly studied as the most viable treatment options for achalasia. The pendulum, however, is shifting to the minimally invasive approach. Since Inoue et al. published the experience of the first 17 cases of peroral endoscopic myotomy (POEM) in 2010, there have been at least 5,000 cases performed worldwide and the number is increasing exponentially. Experts across the globe have been extending the indications to various esophageal motility disorders, to patients of extremes of age, sigmoidal esophagus and re-operated patients...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28616302/esophagogastric-junction-outflow-obstruction-related-functional-chest-pain-treated-using-robotic-assisted-thoracoscopic-esophageal-myotomy
#5
Kuan-Hsun Lin, Shih-Chun Lee, Tsai-Wang Huang, Hsu-Kai Huang
Elevated relaxation pressure in combination with intact or weak peristalsis characterizes esophagogastric junction (EGJ) outflow obstruction. Symptoms of EGJ outflow obstruction include dysphagia and atypical chest pain. EGJ outflow obstruction can be diagnosed using high-resolution manometry (HRM), but there is a lack of consensus regarding treatment. We present a case report of a 43-year-old man with a history of headache and mitral valve disorder who suffered from intermittent atypical chest pain for 20 years...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28602724/achalasia-treatment-outcomes-utilization-and-costs-a-population-based-study-from-the-united-states
#6
Anne P Ehlers, Brant K Oelschlager, Carlos A Pellegrini, Andrew S Wright, Michael D Saunders, David R Flum, Hao He, Farhood Farjah
OBJECTIVE: Randomized trials show that pneumatic dilatation ≥30mm (PD) and laparoscopic myotomy (LM) provide equivalent symptom relief and disease-related quality of life for patients with achalasia. However, there remain questions about the safety, burden, and costs of treatment options. METHODS: We performed a retrospective cohort study of achalasia patients initially treated with PD or LM (2009-2014) using the Truven Health MarketScan® Research Databases. All patients had one year of follow-up after initial treatment...
June 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28575245/peroral-endoscopic-myotomy-versus-surgical-myotomy-for-primary-achalasia-single-center-retrospective-analysis-of-74-patients
#7
S de Pascale, A Repici, F Puccetti, E Carlani, R Rosati, U Fumagalli
Achalasia is a neurodegenerative motility disorder of the esophagus; dysphagia, weight loss, chest pain, and regurgitation are its main symptoms. Surgical myotomy (HM) is considered the gold standard treatment. However, peroral endoscopic myotomy (POEM) seems to be a safe and effective alternative option. The aim of this study is to compare the safety and efficacy of these techniques. From March 2012 to June 2015, 74 patients with symptomatic primary achalasia underwent myotomy. The two groups were compared in terms of intraoperative and postoperative outcomes and Eckardt score at last follow-up...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28566891/ling-classification-describes-endoscopic-progressive-process-of-achalasia-and-successful-peroral-endoscopy-myotomy-prevents-endoscopic-progression-of-achalasia
#8
Wen-Gang Zhang, En-Qiang Linghu, Ning-Li Chai, Hui-Kai Li
AIM: To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy (POEM) to prevent endoscopic progression of achalasia. METHODS: We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients (197 women, 162 men) with a mean age of 42.1 years (range, 12-75 years) were evaluated...
May 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28557560/a-retrospective-study-of-peroral-endoscopic-full-thickness-myotomy-in-patients-with-severe-achalasia
#9
Tianying Duan, Yuyong Tan, Junfeng Zhou, Liang Lv, Deliang Liu
OBJECTIVES: Selective circular myotomy (CM) is recommended in peroral endoscopic myotomy (POEM) for achalasia, but completeness of myotmoy is the prerequisite for excellent long-term results of conventional surgical myotomy. The aim of our study was to compare the efficacy and safety between peroral endoscopic full-thickness and simple CM for the treatment of severe achalasia. MATERIALS AND METHODS: A total of 123 severe achalasia patients who underwent POEM from August 2011 to May 2013 were included...
May 30, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28550869/achalasia
#10
Saleem Islam
Achalasia is a rare neurogenic motility disorder of the esophagus, occurring in approximately 0.11 cases per 100,000 children. The combination of problems (aperistalsis, hypertensive lower esophageal sphincter (LES), and lack of receptive LES relaxation) results in patients having symptoms of progressive dysphagia, weight loss, and regurgitation. Treatment modalities have evolved over the past few decades from balloon dilation and botulinum toxin injection to laparoscopic Heller myotomy and endoscopic myotomy...
April 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28549006/laparoscopic-heller-myotomy-versus-peroral-endoscopic-myotomy-poem-for-achalasia-a-systematic-review-and-meta-analysis
#11
Francisco Schlottmann, Daniel J Luckett, Jason Fine, Nicholas J Shaheen, Marco G Patti
OBJECTIVE: To compare the outcome of per oral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) for the treatment of esophageal achalasia. BACKGROUND: Over the last 2 decades, LHM has become the primary form of treatment in many centers. However, since the first description of POEM in 2010, this technique has widely disseminated, despite the absence of long-term results and randomized trials. METHODS: A systematic Medline literature search of articles on LHM and POEM for the treatment of achalasia was performed...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28542509/functional-restoration-of-the-esophagus-after-peroral-endoscopic-myotomy-for-achalasia
#12
Cheal Wung Huh, Young Hoon Youn, Hyunsoo Chung, Yong Chan Lee, Hyojin Park
PURPOSE: Peroral endoscopic myotomy (POEM) is a new efficacious treatment option for achalasia. We propose to define "esophageal remodeling" as the functional restoration of the esophagus that involves decreased lower esophageal sphincter (LES) pressure, recovery of esophageal body peristalsis, and reduction of luminal diameter. The aim of this study was to investigate "esophageal remodeling" after POEM for achalasia. MATERIALS AND METHODS: We analyzed data from a prospectively collected database of POEM subjects, which included preoperative and 2-month postoperative Eckardt symptom scores, and results from esophageal high resolution manometry (HRM) and barium esophagogram (BE)...
2017: PloS One
https://www.readbyqxmd.com/read/28536813/long-term-outcomes-of-heller-s-myotomy-and-balloon-dilatation-in-childhood-achalasia
#13
Efstratios Saliakellis, Nikhil Thapar, Derek Roebuck, Fernanda Cristofori, Kate Cross, Edward Kiely, Joseph Curry, Keith Lindley, Osvaldo Borrelli
Achalasia is a rare esophageal motility disorder: its optimal treatment in children is still a matter of debate. Records of children treated for achalasia, over an 18-year period, were reviewed.Forty-eight children (median age at diagnosis 10 years; range 3-17 years) were identified. Twenty-eight patients were initially treated with Heller's myotomy (HM) and 20 with balloon dilatation (BD). At last follow-up (median 3 years; range 1-5.5 years), 43.8% (21/48) of children were symptom free. The number of asymptomatic children was significantly higher among those treated initially with HM compared to BD (HM 15/28, 53...
May 23, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28534521/comprehensive-analysis-of-adverse-events-associated-with-per-oral-endoscopic-myotomy-in-1826-patients-an-international-multicenter-study
#14
Yamile Haito-Chavez, Haruhiro Inoue, Kristin W Beard, Peter V Draganov, Michael Ujiki, Burkhard H A Rahden, Pankaj N Desai, Mathieu Pioche, Bu Hayee, Amyn Haji, Payal Saxena, Kevin Reavis, Manabu Onimaru, Valerio Balassone, Jun Nakamura, Yoshitaka Hata, Dennis Yang, Davinderbir Pannu, Ali Abbas, Yaseen B Perbtani, Lava Y Patel, Jorg Filser, Sabine Roman, Jerome Rivory, Francois Mion, Thierry Ponchon, Silvana Perretta, Vivien Wong, Roberta Maselli, Saowanee Ngamruengphong, Yen-I Chen, Majidah Bukhari, Gulara Hajiyeva, Amr Ismail, Renata Pieratti, Vivek Kumbhari, Gerson Galdos-Cardenas, Alessandro Repici, Mouen A Khashab
OBJECTIVES: The safety of peroral endoscopic myotomy (POEM) is still debated since comprehensive analysis of adverse events (AEs) associated with the procedure in large multicenter cohort studies has not been performed. To study (1) the prevalence of AEs and (2) factors associated with occurrence of AEs in patients undergoing POEM. METHODS: Patients who underwent POEM at 12 tertiary-care centers between 2009 and 2015 were included in this case-control study. Cases were defined by the occurrence of any AE related to the POEM procedure...
May 23, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28528063/an-involuntary-and-unexpected-treatment-of-nutcracker-esophagus
#15
Diane Mege, Alban Benezech, Henri de Lesquen, Véronique Vitton, Pascal-Alexandre Thomas
A 76-year-old woman complained of painful dysphagia and loss of weight. Esophagoscopy results were negative, whereas computed tomography (CT) disclosed a 25-mm mediastinal tumor without a connection to the esophagus. A diagnosis of nutcracker esophagus was made on high-resolution esophageal manometry. Peroral endoscopic esophageal myotomy failed to improve the symptoms. Right video thoracoscopy allowed resection of the tumor, which looked like a neurogenic tumor of the posterior mediastinum that developed from the right vagus nerve...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28496526/changing-trends-in-age-gender-racial-distribution-and-inpatient-burden-of-achalasia
#16
Vaibhav Wadhwa, Prashanthi N Thota, Malav P Parikh, Rocio Lopez, Madhusudhan R Sanaka
BACKGROUND: Achalasia is an idiopathic esophageal motility disorder characterized by dysphagia, regurgitation, chest discomfort and weight loss. The aim of this study was to evaluate the temporal trends in demographic variables, interventions, and inpatient burden in achalasia-related hospitalizations. METHODS: We evaluated the National Inpatient Sample Database (NIS) for all patients in whom achalasia (ICD-9 code: 530.0) was the principal discharge diagnosis from 1997 to 2013...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28484733/per-oral-endoscopic-myotomy-for-achalasia-cardia-outcomes-in-over-400-consecutive-patients
#17
Zaheer Nabi, Mohan Ramchandani, Radhika Chavan, Rakesh Kalapala, Santosh Darisetty, Guduru Venkat Rao, Nageshwar Reddy
Background and study aims Per-oral endoscopic myotomy (POEM) has emerged as an efficacious treatment modality for the management of achalasia cardia (AC) and non-achalasia spastic esophageal motility disorders. Initial results are encouraging. We analyzed the safety and efficacy of POEM in a large cohort of patients with AC. Patients and methods The data from patients who underwent POEM (from January 2013 to June 2016) was prospectively collected and analyzed. Clinical success was defined as Eckardt score ≤ 3 after POEM procedure...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28475741/clinical-presentation-and-disease-course-of-patients-with-esophagogastric-junction-outflow-obstruction
#18
K L Lynch, Y-X Yang, D C Metz, G W Falk
Esophagogastric junction outflow obstruction, characterized by preserved peristalsis in conjunction with an elevated integrated relaxation pressure, can result from specific anatomic variants or may represent achalasia in evolution. There is limited information on the clinical significance of this diagnosis. The aim of this study is to describe the clinical characteristics and outcomes in our cohort of patients with esophagogastric junction outflow obstruction.Consecutive adult patients who had undergone high-resolution esophageal manometry between February 2013 and November 2015 with a diagnosis of esophagogastric junction outflow obstruction were identified...
June 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28472834/gastroesophageal-reflux-after-peroral-endoscopic-myotomy-a-multicenter-case-control-study
#19
Vivek Kumbhari, Pietro Familiari, Niels Christian Bjerregaard, Mathieu Pioche, Edward Jones, Weon Jin Ko, Bu Hayee, Anna Cali, Saowanee Ngamruengphong, Francois Mion, Ruben Hernaez, Sabine Roman, Alan H Tieu, Mohamad El Zein, Tokunbo Ajayi, Amyn Haji, Joo Young Cho, Jeffrey Hazey, Kyle A Perry, Thierry Ponchon, Rastislav Kunda, Guido Costamagna, Mouen A Khashab
Background and study aims The variables associated with gastroesophageal reflux (GER) after peroral endoscopic myotomy (POEM) are largely unknown. This study aimed to: 1) identify the prevalence of reflux esophagitis and asymptomatic GER in patients who underwent POEM, and 2) evaluate patient and intraprocedural variables associated with post-POEM GER. Patients and methods All patients who underwent POEM and subsequent objective testing for GER (pH study with or without upper gastrointestinal [GI] endoscopy) at seven tertiary academic centers (one Asian, two US, four European) were included...
May 4, 2017: Endoscopy
https://www.readbyqxmd.com/read/28451814/the-relationship-between-manometric-subtype-and-outcomes-of-surgical-treatment-for-patients-with-achalasia-achalasia-manometric-subtypes
#20
Oscar Maximiliano Crespin, Roger Perry Tatum, Keliang Xiao, Ana Valeria Martin, Saurabh Khandelwal, Carlos Alberto Pellegrini, Brant Kurt Oelschlager
BACKGROUND: The Chicago Classification describes three distinct subtypes of achalasia and it appears to be a promising tool in predicting results of treatment with standard Heller Myotomy. The aim of this study is to analyze the outcomes of surgical treatment for achalasia using an extended Heller myotomy for each subtype and to identify additional parameters that may predict the success of therapy. METHODS: 72 consecutive patients with achalasia were evaluated at the University of Washington between 2008 and 2013...
April 27, 2017: Surgical Endoscopy
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