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Esophageal myotomy

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https://www.readbyqxmd.com/read/28100060/boerhaave-s-syndrome-diagnostic-gastroscopy
#1
Rocío Ferreiro-Iglesias, Manuel Narciso Blanco Freire, Manuel Paz Novo, J Enrique Domínguez Muñoz
A 47-year-old man was attended at the emergency room for severe chest pain after eating sausage with subsequent vomiting and mild upper gastrointestinal bleeding. In the chest radiography we could not see abnormalities. He referred previous episodes of choking without consulting. The urgent gastroscopy detected tertiary contractile activity (nutcracker esophagus) and a foreign body in the lower third of the esophagus. After removing the food bolus, we observed a 4 cm longitudinal tear compatible with esophageal rupture or Boerhaave's syndrome in the right posterior wall of the lower esophagus, proximal to the gastroesophageal junction...
January 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28099056/multidisciplinary-approach-to-esophageal-achalasia-a-single-center-experience
#2
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
#3
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/28039638/effects-of-laparoscopic-myotomy-on-the-esophageal-motility-pattern-of-esophageal-achalasia-as-measured-by-high-resolution-manometry
#4
Renato Salvador, Edoardo Savarino, Elisa Pesenti, Lorenzo Spadotto, Guerrino Voltarel, Giovanni Capovilla, Francesco Cavallin, Loredana Nicoletti, Michele Valmasoni, Alberto Ruol, Stefano Merigliano, Mario Costantini
BACKGROUND: Esophageal achalasia can be classified on the grounds of three distinct manometric patterns that correlate well with final outcome after laparoscopic Heller-Dor myotomy (LHM). No analytical data are available, however, on the postoperative picture and its possible correlation with final outcome. The aims of this study were: (a) to investigate whether manometric patterns change after LHM for achalasia; (b) to ascertain whether postoperative patterns and/or changes can predict final outcome; and (c) to test the hypothesis that the three known patterns represent different stages in the evolution of the disease...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28011013/health-related-quality-of-life-after-laparoscopic-heller-myotomy-and-dor-fundoplication-for-achalasia
#5
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/27973949/robot-assisted-heller-s-myotomy-for-achalasia-in-children
#6
Tariq Altokhais, Hala Mandora, Ayed Al-Qahtani, Abdulrahman Al-Bassam
BACKGROUND: Achalasia is rare in children. Surgical options include open, laparoscopic and robotic approaches. However, Heller's myotomy remains the treatment of choice. This report describes our experience with robot-assisted Heller's myotomy in children and presents a review of the literature. METHODS: Included in this study are children who underwent robot-assisted Heller's myotomy for esophageal achalasia via the Da Vinci surgical system between 2004 and 2015 at King Saud University Medical City, Riyadh, Saudi Arabia...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27967203/peroral-endoscopic-myotomy-for-an-achalasia-patient-with-multiple-esophageal-diverticula
#7
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/27931636/complications-of-submucosal-endoscopy
#8
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
#9
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
https://www.readbyqxmd.com/read/27921057/endoscopic-management-of-an-intramural-sinus-leak-after-per-oral-endoscopic-myotomy
#10
Haider Al Taii, Bradley Confer, Scott Gabbard, Matthew Kroh, Sunguk Jang, John Rodriguez, Mansour A Parsi, John J Vargo, Jeffrey Ponsky, Amit Bhatt
Per-oral endoscopic myotomy (POEM) was developed less than a decade ago for the treatment of achalasia. Its minimally invasive approach and the favorable short-term outcome have led to rapid adoption of the technique throughout the world. As with any new technique, there will be adverse events, and it is important that effective treatments for these adverse events be discussed. We present a case of successful endoscopic management of an intramural sinus leak after a POEM procedure using tandem fully covered esophageal stents...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27909548/microvasculature-of-the-esophagus-and-gastroesophageal-junction-lesson-learned-from-submucosal-endoscopy
#11
REVIEW
Roberta Maselli, Haruhiro Inoue, Haruo Ikeda, Manabu Onimaru, Akira Yoshida, Esperanza Grace Santi, Hiroki Sato, Bu'Hussain Hayee, Shin-Ei Kudo
Advanced therapeutic endoscopy, in particular endoscopic mucosal resection, endoscopic submucosal dissection, per-oral endoscopic myotomy, submucosal endoscopic tumor resection opened a new era where direct esophageal visualization is possible. Combining these information with advanced diagnostic endoscopy, the esophagus is organized, from the luminal side to outside, into five layers (epithelium, lamina propria with lamina muscularis mucosa, submucosa, muscle layer, adventitia). A specific vascular system belonging to each layer is thus visible: Mucosa with the intra papillary capillary loop in the epithelium and the sub-epithelial capillary network in the lamina propria and, at the lower esophageal sphincter (LES) level with the palisade vessels; submucosa with the drainage vessels and the spindle veins at LES level; muscle layer with the perforating vessels; peri-esophageal veins in adventitia...
November 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27901639/results-of-laparoscopic-heller-s-myotomy-for-achalasia-in-children-a-systematic-review-of-the-literature
#12
Maurizio Pacilli, Mark Davenport
INTRODUCTION: Achalasia is a rare disorder in children who are commonly treated by laparoscopic Heller's myotomy (LHM). However, there are no large studies evaluating the results of LHM in the pediatric population, and the need of a concomitant fundoplication remains unclear. The aim of the study is to appraise the results of LHM based on a systematic literature review. MATERIALS AND METHODS: MEDLINE search of the English literature was performed for "achalasia," "children," "laparoscopy," "Heller," "myotomy," and "cardiomyotomy...
January 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27895430/full-thickness-myotomy-is-associated-with-higher-rate-of-postoperative-gastroesophageal-reflux-disease
#13
Xue-Hong Wang, Yu-Yong Tan, Hong-Yi Zhu, Chen-Jie Li, De-Liang Liu
AIM: To compare long-term occurrence of gastroesophageal reflux disease (GERD) between two different types of peroral endoscopic myotomy (POEM) for achalasia. METHODS: We included all patients with achalasia who underwent POEM at our hospital from August 2011 to October 2012 and had complete GERD evaluation with ≥ 3 years of follow-up. They were divided into circular or full-thickness myotomy groups according to the depth of myotomy. Demographics, Eckardt score, manometry results, 24-h pH monitoring, and GERD symptoms were recorded and compared between the two groups...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27878898/feasibility-and-safety-of-peroral-endoscopic-myotomy-for-achalasia-after-failed-endoscopic-interventions
#14
X Tang, W Gong, Z Deng, J Zhou, Y Ren, Q Zhang, Z Chen, B Jiang
With advances in natural orifice transluminal endoscopic surgery, peroral endoscopic myotomy (POEM) has become a novel treatment for esophageal achalasia. In this study, we investigated the feasibility and safety of POEM in patients with achalasia after failed endoscopic interventions. Data on all patients undergoing POEM treatment of achalasia were collected prospectively. We enrolled 61 patients who underwent POEM for achalasia between July 2011 and January 2014. The preoperative intervention group included patients who had undergone botulinum toxin injection or pneumatic balloon dilation before POEM...
November 23, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27859721/analysis-of-the-learning-curve-of-peroral-endoscopic-myotomy-for-esophageal-achalasia-single-center-two-operator-experience
#15
Lv Houning, Ningning Zhao, Zhongqing Zheng, Tao Wang, Fang Yang, Xihui Jiang, Lin Lin, Chao Sun, Bangmao Wang
OBJECTIVES: Peroral endoscopic myotomy (POEM) has emerged as an advanced technique for the treatment of achalasia, and defining the learning curve is mandatory. METHODS: From August 2011 to June 2014, two operators in our institution (A&B) have performed POEM on 35 and 33 consecutive patients, respectively. The moving average and cumulative sum (CUSUM) methods were employed to analyze the POEM learning curve for corrected operative time (cOT), referring to duration of per centimeter myotomy...
November 17, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27858325/is-poem-the-answer-for-management-of-spastic-esophageal-disorders-a-systematic-review-and-meta-analysis
#16
REVIEW
Muhammad Ali Khan, Vivek Kumbhari, Saowanee Ngamruengphong, Amr Ismail, Yen-I Chen, Yamile Haito Chavez, Majidah Bukhari, Richard Nollan, Mohammad Kashif Ismail, Manabu Onimaru, Valerio Balassone, Ahmed Sharata, Lee Swanstrom, Haruhiro Inoue, Alessandro Repici, Mouen A Khashab
BACKGROUND AND AIMS: Spastic esophageal disorders (SEDs) include spastic achalasia (type III), diffuse esophageal spasm (DES), and nutcracker/jackhammer esophagus (JH). Per-oral endoscopic myotomy (POEM) has demonstrated efficacy and safety in the treatment of achalasia. Recently, POEM has been indicated for the treatment of SEDs. We conducted a systematic review and meta-analysis to determine the clinical success and safety of POEM in SEDs. METHODS: We searched several databases from 01/01/2007 to 01/10/2016 to identify studies (with five or more patients) on POEM for the treatment of SEDs...
January 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27846179/real-time-continuous-esophageal-high-resolution-manometry-hrm-during-laparoscopic-heller-myotomy-and-dor-fundoplication-for-the-treatment-of-achalasia-a-promising-novelty-in-regards-of-perfecting-surgical-technique-could-it-guide-surgical-technique-toward-excellent
#17
Tania Triantafyllou, Georgia Doulami, Joanna Papailiou, Apostolos Mantides, Georgios Zografos, Dimitrios Theodorou
High-resolution manometry (HRM) is the gold-standard diagnostic tool for achalasia of the esophagus. Laparoscopic Heller-Dor technique is the preferred surgical approach with success rate estimated 90%. The use of intraoperative HRM provides real-time estimation of intraluminal esophageal pressures and identifies the exact points of esophageal luminal pressure during laparoscopy. Ten patients with achalasia underwent surgery. All patients preoperatively completed 1 manometric study and Quality of Life questionnaires (EORTC QLQ-C30 version 3...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27822780/intramural-esophageal-bronchogenic-cyst-mimicking-achalasia-in-a-toddler
#18
Jessica S Lin, Yangyang R Yu, Eric H Chiou, Bruno P Chumpitazi, Deborah A Schady, Mary L Brandt
Bronchogenic cysts are congenital malformations of the tracheobronchial tree. We describe a 20-month-old male who presented with persistent non-bilious emesis; manometry and imaging were consistent with esophageal achalasia. During a planned laparoscopic Heller myotomy, an intramural bronchogenic cyst was discovered in the anterior esophagus at the level of the gastroesophageal junction and successfully resected with resolution of his symptoms.
November 7, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27818585/update-on-the-endoscopic-treatments-for-achalasia
#19
REVIEW
Dushant S Uppal, Andrew Y Wang
Achalasia is the most common primary motility disorder of the esophagus and presents as dysphagia to solids and liquids. It is characterized by impaired deglutitive relaxation of the lower esophageal sphincter. High-resolution manometry allows for definitive diagnosis and classification of achalasia, with type II being the most responsive to therapy. Since no cure for achalasia exists, early diagnosis and treatment of the disease is critical to prevent end-stage disease. The central tenant of diagnosis is to first rule out mechanical obstruction due to stricture or malignancy, which is often accomplished by endoscopic and fluoroscopic examination...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27785316/pharyngoesophageal-obstruction-on-the-killian-laimer-triangle-by-zenker-s-diverticulum-case-report-and-clinical-significance
#20
Tulio F Leite, Carlos A A Chagas, Lucas A S Pires, Rafael Cisne, Marcio A Babinski
Zenker's diverticulum is a form of esophageal and pharyngeal obstruction located at the Killian-Laimer triangle. It is relatively common in elderly man (seventh or eighth decade of life), and its pathophysiology is not completely understood, albeit theories regarding dysfunction of the upper esophageal sphincter were reported. The main symptoms are dysphagia and odynophagia, but it can complicate to aspiration and perforation of the pharyngeal pouch; also, it can be asymptomatic. Diagnosis is provided through a barium esophagogram...
December 2015: Gastroenterology Research
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