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Esophageal myotomy

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https://www.readbyqxmd.com/read/29674757/ten-initial-cases-of-peroral-endoscopic-myotomy-for-treatment-of-esophageal-motility-disorders-at-okayama-university-hospital
#1
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
#2
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
https://www.readbyqxmd.com/read/29657705/laparoscopic-transhiatal-resection-of-a-large-mid-esophageal-diverticulum-a-case-report
#3
Tomislav Tokic, Iva Kirac, Davor Hrabar, Branko Troskot, Miroslav Bekavac-Beslin
This is a description of transhiatal laparoscopic approach for mid-esophageal diverticulum. Traditionally mid-esophageal diverticula are approached by thoracotomy or thoracoscopy, with the laparoscopic technique being reserved for epiphrenic diverticula. A 78-year-old Caucasian female with a secondary dilatative ischemic cardiomyopathy presented with dysphagia, tenderness in the epigastrium and a considerable weight loss. A large mid-esophageal diverticulum was found on barium swallow and confirmed by CT scan...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29656451/patient-with-mediastinitis-caused-by-delayed-mucosal-damage-after-peroral-endoscopic-myotomy
#4
Hiroki Okada, Hironari Shiwaku, Kanefumi Yamashita, Toshihiro Ohmiya, Haruhiro Inoue, Suguru Hasegawa
Peroral endoscopic myotomy (POEM) is a groundbreaking procedure for treating esophageal achalasia, and many reports from various facilities have described its safety and efficacy. However, there have been few reports on adverse events. Here, we report a case of a patient with mediastinitis caused by delayed mucosal damage after POEM. This case was the most severe among all POEM cases at our hospital. A 58-year-old man had experienced dysphagia and chest tightness since he was around 50 years old. At a previous hospital, he had been diagnosed with nonerosive reflux disease and had undergone fundoplication...
April 15, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29642692/noncardiac-chest-pain-a-2018-update
#5
Marilena Durazzo, Giuseppe Gargiulo, Rinaldo Pellicano
Noncardiac chest pain (NCCP) is defined as recurring, angina-like, chest pain of noncardiac origin. Studies have estimated that gastroesophageal reflux disease (GERD) is the most common contributing factor for NCCP. In patients with non-GERD related NCCP, esophageal motility disorders, and functional chest pain (FCP) of presumed esophageal origin are the main underlying mechanisms for symptoms. Epidemiologic studies show a high prevalence of panic disorder, anxiety and major depression in NCCP patients. The diagnostic esophageal workup starts only after that cardiac and pulmonary diseases have been ruled out...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29627183/value-of-routine-timed-barium-esophagram-follow-up-in-achalasia-after-myotomy
#6
Stefan S Kachala, Thomas W Rice, Mark E Baker, Jeevanantham Rajeswaran, Prashanthi N Thota, Sudish C Murthy, Eugene H Blackstone, Andrea Zanoni, Siva Raja
OBJECTIVES: The value of routine timed barium esophagram (TBE) in longitudinal follow-up of achalasia after Heller myotomy is unknown. We prospectively prescribed a yearly follow-up TBE. Purposes were to characterize esophageal emptying over time after myotomy, identify preoperative TBE measures associated with follow-up TBE, and characterize follow-up TBE over time in relationship to reintervention. METHODS: From March 1995 to April 2013, 635 patients underwent Heller myotomy for achalasia; 559 had at least 1 follow-up TBE...
March 8, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29617752/muscle-layer-thickness-affects-the-peroral-endoscopic-myotomy-procedure-complexity
#7
D Watanabe, S Tanaka, R Ariyoshi, H Abe, F Kawara, T Toyonaga
Esophageal motility disorders can cause severe dysphagia, regurgitation, and/or noncardiac chest pain due to a lack of coordinated esophageal motility function. However, the clinical significance of esophageal muscle layer thickness remains unclear. The aims of this study are to elucidate the clinical significance of esophageal muscle layer thickness in patients with esophageal motility disorders who undergo peroral endoscopic myotomy (POEM), and to identify predictors of a longer POEM procedure time. Seventy-four consecutive patients with esophageal motility disorders who underwent POEM procedures at Kobe University Hospital from April 2015 to December 2016 were prospectively recruited into this study...
March 28, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29608597/a-clinical-study-of-peroral-endoscopic-myotomy-reveals-that-impaired-lower-esophageal-sphincter-relaxation-in-achalasia-is-not-only-defined-by-high-resolution-manometry
#8
Hiroki Sato, Kazuya Takahashi, Ken-Ichi Mizuno, Satoru Hashimoto, Junji Yokoyama, Shuji Terai
BACKGROUND AND AIM: Achalasia is an esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation. On high-resolution manometry (HRM), impaired LES relaxation is defined by elevated integrated relaxation pressure (IRP). However, a new category of achalasia within the normal IRP range has been suggested. METHODS: HRM was performed using a Starlet device and an IRP threshold of 26 mmHg. Peroral endoscopic myotomy (POEM) was performed for cases of achalasia diagnosed using established methods...
2018: PloS One
https://www.readbyqxmd.com/read/29580341/laparoscopic-heller-myotomy-with-anterior-fundoplication-improves-frequency-and-severity-of-symptoms-of-achalasia-regardless-of-preoperative-severity-determined-by-esophagography
#9
Alexander Rosemurgy, Darrell Downs, Kenneth Luberice, Christian Rodriguez, Forat Swaid, Krishen Patel, Paul Toomey, Sharona Ross
This study was undertaken to determine whether postoperative outcomes after laparoscopic Heller myotomy with anterior fundoplication could be predicted by preoperative findings on esophagography. Preoperative barium esophagograms of 135 patients undergoing laparoscopic Heller myotomy with anterior fundoplication were reviewed. The number of esophageal curves, esophageal width, and angulation of the gastroesophageal junction (GEJ) were determined; correlations between these determined parameters and symptoms were assessed using linear regression analysis...
February 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29571969/efficacy-of-anterior-versus-posterior-per-oral-endoscopic-myotomy-for-treating-achalasia-a-randomized-prospective-study
#10
Yuyong Tan, Liang Lv, Xuehong Wang, Hongyi Zhu, Yi Chu, Min Luo, Chenjie Li, Hejun Zhou, Jirong Huo, Deliang Liu
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) has been demonstrated to be safe and effective for treating achalasia. Two approaches-anterior myotomy and posterior myotomy-are used during POEM. However, little is known about the comparison between the two different approaches. The objective of the study is to compare the safety and short-term efficacy of the 2 approaches for treating achalasia. METHODS: From October 2015 to December 2016, 63 consecutive patients with achalasia without prior treatment or sigmoid-type esophagus were prospectively recruited...
March 20, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29509532/high-resolution-manometry-a-mandatory-examination-in-the-pre-and-postoperative-assessment-of-patients-with-achalasia
#11
Anca Dimitriu, Cristian Gheorghe
High resolution manometry (HRM) is currently the gold standard for the diagnosis of achalasia and other functional esophageal disorders. All patients accusing dysphagia should be endoscopically evaluated prior to manometric investigations in order to rule out pseudoachalasia. The Chicago HRM classification has led to a subclassification of three manometric types of achalasia that seem to have different results to treatment. None of the actual achalasia treatment options are curative. Type II achalasia patients respond best to all treatment options compared to those with types I and III...
January 2018: Chirurgia
https://www.readbyqxmd.com/read/29496268/peroral-endoscopic-myotomy-for-the-treatment-of-achalasia-and-other-esophageal-motor-disorders-short-term-and-medium-term-results-at-a-mexican-tertiary-care-center
#12
O V Hernández-Mondragón, O M Solórzano-Pineda, M A González-Martínez, J M Blancas-Valencia, C Caballero-Luengas
INTRODUCTION AND AIMS: Achalasia is characterized by the absence of lower esophageal sphincter relaxation and esophageal aperistalsis. Diagnosis is confirmed through high-resolution esophageal manometry. Laparoscopic myotomy is the standard treatment, but peroral endoscopic myotomy (POEM) is a safe and effective alternative, with good short-term and medium-term results. Our aim was to describe the short-term and medium-term experience with POEM at a tertiary care center. MATERIALS AND METHODS: The study was conducted within the time frame of November 2014 and February 2017...
February 26, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29488045/bladder-pressure-monitoring-and-co-2-gas-related-adverse-events-during-per-oral-endoscopic-myotomy
#13
Mari Yamashita-Ichimura, Emiko Toyama, Makoto Sasoh, Hironari Shiwaku, Kanefumi Yamashita, Yuichi Yamashita, Ken Yamaura
Per-oral endoscopic myotomy (POEM) is a minimally invasive treatment for esophageal achalasia. However, POEM has the potential risk of inducing carbon dioxide (CO2 ) gas-related adverse events, such as pneumoperitoneum, pneumomediastinum, and pneumothorax. The aim of this study was to evaluate the usability of bladder pressure monitoring as an index of CO2 gas-related pneumoperitoneum. The monitoring of bladder pressure and lung compliance and the incidence of iatrogenic pneumoperitoneum were retrospectively studied in 20 patients who underwent POEM between June 2013 and March 2015...
February 27, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29482980/esophageal-obstruction-due-to-a-right-sided-zenker-diverticulum
#14
S Mantziari, C Mariette, G Piessen
A Zenker's or pharyngoesophageal diverticulum may represent a rare cause of upper digestive obstruction, or more often, cervical dysphagia, regurgitations and cough. It develops most often on the posterior left side of cervical oesophagus in elderly patients, and depending on the severity of clinical symptoms may warrant surgical or endoscopic treatment. For large lesions with a difficult endoscopic access to the diverticular neck, surgery is recommended. In our case, we illustrate a giant right-sided Zenker's diverticulum responsible for complete aphagia in a 78-year-old male patient...
February 23, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29480864/retrograde-gastroesophageal-intussusception-after-peroral-endoscopic-myotomy-in-a-patient-with-achalasia-cardia-a-case-report
#15
Samiullah Khan, Shuai Su, Kui Jiang, Bang-Mao Wang
RATIONALE: Retrograde gastroesophageal intussusception (RGEI) is a relatively rare gastrointestinal (GI) disorder in which a portion of the stomach wall invaginates into the esophagus. More recently, peroral endoscopic myotomy (POEM) has emerged as an endoscopic alternative to surgical myotomy for achalasia, and, to the best of our knowledge, our case is the first RGEI after POEM to be reported. PATIENT CONCERNS: A 22-year-old male was presented with a history of vomiting, intractable retching and hematemesis for 3 days...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29468376/gastric-per-oral-endoscopic-myotomy-g-poem-for-the-treatment-of-refractory-gastroparesis-early-experience
#16
Zubair Malik, Rahul Kataria, Rani Modayil, Adam C Ehrlich, Ron Schey, Henry P Parkman, Stavros N Stavropoulos
BACKGROUND: Gastric per oral endoscopic myotomy (G-POEM) of the pylorus is a technique that is recently being used to treat gastroparesis. Our aim was to report our experience in performing G-POEM for refractory gastroparesis of different etiologies and determine symptom improvement. METHODS: Thirteen patients undergoing G-POEM are reported. Pre- and post-procedure gastric emptying study (GES) and PAGI-SYM for symptom severity were obtained. Patients underwent G-POEM by creating a submucosal tunnel starting in the greater curvature of the distal antrum and extending it to the beginning of the duodenal bulb, followed by a full thickness pyloromyotomy...
February 22, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29454796/endoscopic-myotomy-for-foregut-motility-disorders
#17
Mouen A Khashab, Petros C Benias, Lee L Swanstrom
Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure classically performed for the treatment of achalasia. The procedure is based on principles of submucosal endoscopy and is comprised of a mucosal incision, submucosal tunneling, myotomy and mucosal closure. Multiple published studies that collectively include more than 6000 patients reported clinical success in more than 80-90% of patients. Recent literature also suggested durability of response over a medium-term follow-up. POEM is associated with a low rate of adverse events when performed by experienced operators...
February 15, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29452437/successful-treatment-of-giant-esophageal-diverticulum-by-per-oral-endoscopic-myotomy
#18
Chuncheng Wu, Qiongying Zhang, Wei Liu, Bing Hu
No abstract text is available yet for this article.
February 16, 2018: Endoscopy
https://www.readbyqxmd.com/read/29452429/less-invasive-than-minimally-invasive-peroral-endoscopic-myotomy-with-a-slim-scope-in-the-treatment-of-esophageal-achalasia
#19
Antonio Carlos Coelho Conrado, Joao Guilherme Guerra, Claudio Lyoiti Hashimoto, Marcelo Averbach, Miguel Arcanjo Dos Santos, Peter Vassilev Draganov
No abstract text is available yet for this article.
February 16, 2018: Endoscopy
https://www.readbyqxmd.com/read/29447795/modified-approach-for-pediatric-external-cricopharyngeal-myotomy
#20
Suresh Mohan, Sarah N Bowe, Lara M Hirner, Claire Zar-Kessler, Christopher J Hartnick
Pediatric cricopharyngeal achalasia is an uncommon but important cause of oropharyngeal dysphagia. Failure of upper esophageal sphincter relaxation is the currently understood pathophysiology. Therapies include balloon dilation, botulinum toxin injection, and endoscopic or open cricopharyngeal myotomy (CPM). Open CPM is usually performed at the posterior midline of the cricopharyngeus and can be a risky procedure given concern for esophageal perforation and damage to the recurrent laryngeal nerve. Here, we present a novel modified technique for open CPM using a superficial anterolateral transection approach in the case of a young male with refractory cricopharyngeal achalasia...
February 2018: International Journal of Pediatric Otorhinolaryngology
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