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https://www.readbyqxmd.com/read/28637650/achalasia-leading-to-diagnosis-of-adenocarcinoma-of-the-oesophagus
#1
Jonathan Segal, Ayodele Lagundoye, Martyn Carter
A 50-year-old male with a 7 month history of progressive dysphagia to solids then subsequently to liquids. He underwent a diagnostic gastroscopy which was normal. A further barium swallow suggested achalasia. He was referred to a tertiary centre, where he underwent pH and manometry studies which confirmed a diagnosis of achalasia. He was referred for a laparoscopic cardiomyotomy, and at surgery there was a suspected tumour at the gastro-oesophageal junction. A follow-up endoscopy with biopsies was normal...
June 20, 2017: BMJ Case Reports
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/28617881/is-heller-myotomy-better-than-balloon-dilation-a-meta-analysis
#3
Anita Illés, Nelli Farkas, Péter Hegyi, András Garami, Imre Szabó, Margit Solymár, Erika Pétervári, Márta Balaskó, Gabriella Pár, Patrícia Sarlós, Judit Bajor, Ákos Szűcs, József Czimmer, Kata Szemes, Áron Vincze
BACKGROUND AND AIM: Endoscopic balloon dilation (EBD) and laparoscopic Heller myotomy (LHM) are the most commonly performed treatment options for achalasia. Decision between these treatment options is difficult. The aim of this meta-analysis was to evaluate the efficacy of EBD compared to LHM. METHODS: The electronic databases PubMed, Embase and Cochrane Controlled Trials Registry were systematically searched for the period between January 1, 1976 and December 31, 2015...
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
#4
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
#5
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/28604515/novel-pressure-impedance-parameters-for-evaluating-esophageal-function-in-pediatric-achalasia
#6
Maartje M J Singendonk, Taher I Omari, Nathalie Rommel, Michiel P van Wijk, Marc A Benninga, Rachel Rosen, Samuel Nurko
OBJECTIVE: In achalasia, absent peristalsis and reduced esophagogastric junction (EGJ) relaxation and compliance underlie dysphagia symptoms. Novel high-resolution impedance manometry (HRIM) variables, i.e. bolus presence time (BPT) and trans-EGJ-bolus flow time (BFT) have been developed to estimate the duration of EGJ opening and trans-EGJ bolus flow. The aim of this study was to evaluate esophageal motor function and bolus flow in children diagnosed with achalasia using these variables...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28602724/achalasia-treatment-outcomes-utilization-and-costs-a-population-based-study-from-the-united-states
#7
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/28593551/esophageal-motility-disorders-symptomatic-and-manometric-spectrum-in-punjab-northern-india
#8
Omesh Goyal, Monika Bansal, Ajit Sood
BACKGROUND: Data on the spectrum of esophageal motility disorders in Indian population are scarce. We aimed to study the symptomatic and manometric profile of patients with suspected esophageal motility disorders. METHODS: Consecutive patients with esophageal symptoms who underwent esophageal high-resolution manometry (HRM) from January 2010 to December 2014 were included in this retrospective analysis of prospectively acquired data. HRM was performed with 22-channel water-perfusion system and patients classified using Chicago classification v3...
June 8, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28585270/intra-and-interrater-reliability-of-the-chicago-classification-of-achalasia-subtypes-in-pediatric-high-resolution-esophageal-manometry-hrm-recordings
#9
M M J Singendonk, R Rosen, J Oors, N Rommel, M P van Wijk, M A Benninga, S Nurko, T I Omari
BACKGROUND: Subtyping achalasia by high-resolution manometry (HRM) is clinically relevant as response to therapy and prognosis have shown to vary accordingly. The aim of this study was to assess inter- and intrarater reliability of diagnosing achalasia and achalasia subtyping in children using the Chicago Classification (CC) V3.0. METHODS: Six observers analyzed 40 pediatric HRM recordings (22 achalasia and 18 non-achalasia) twice by using dedicated analysis software (ManoView 3...
June 6, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28576606/difference-of-achalasia-subtypes-based-on-clinical-symptoms-radiographic-findings-and-stasis-scores
#10
A Meillier, D Midani, D Caroline, M Saadi, H Parkman, R Schey
INTRODUCTION: Three subtypes of achalasia have been defined through high-resolution esophageal manometry: subtype i shows no pressurization with swallows, subtype ii has increased isobaric panesophageal pressure, and subtype iii has distal esophageal spastic non-isobaric contractions. Studies describing the subtypes based on radiographic findings, clinical symptoms, and stasis scores are limited. AIM: To determine the differences in clinical symptoms, radiographic findings, and stasis scores for the 3 achalasia subtypes...
May 30, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28575249/esophageal-distensibility-measurement-impact-on-clinical-management-and-procedure-length
#11
N K Ahuja, A Agnihotri, K L Lynch, D Hoo-Fatt, F Onyimba, M McKnight, F C Okeke, P Garcia, S Dhalla, E Stein, P J Pasricha, J O Clarke
Luminal distensibility measurement has demonstrated relevance to various disease processes, though its effects on clinical decision-making have been less well understood. This study aims to characterize the clinical impact of impedance planimetry measurement as well as the learning curve associated with its use in the esophagus. A single provider performed distensibility measurement in conjunction with upper endoscopy for a variety of clinical indications with the functional lumen imaging probe (FLIP) over a period of 21 months...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28575245/peroral-endoscopic-myotomy-versus-surgical-myotomy-for-primary-achalasia-single-center-retrospective-analysis-of-74-patients
#12
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/28574971/per-oral-endoscopic-myotomy-in-children-first-experience-with-a-new-triangular-knife
#13
Zaheer Nabi, Mohan Ramchandani, Radhika Chavan, Manu Tandan, Rakesh Kalapala, Santosh Darisetty, D Nageshwar Reddy
OBJECTIVES: Per-oral endoscopic myotomy (POEM) is a novel treatment modality for achalasia cardia (AC). The procedure is technically challenging and time consuming. Recently, a new triangle knife (TTJ) has been introduced which is equipped with water jet facility. In this study, we analysed the feasibility, safety and efficacy of POEM in children with new triangle tip knife. METHODS: We retrospectively evaluated the data of children (≤18 years) who underwent POEM using TTJ knife at our institution...
June 2, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28574218/a-novel-mutation-in-gmppa-in-siblings-with-apparent-intellectual-disability-epilepsy-dysmorphism-and-autonomic-dysfunction
#14
Wendy A Gold, Nara Sobreira, Elsa Wiame, Alexandre Marbaix, Emile Van Schaftingen, Patricia Franzka, Lisa G Riley, Lisa Worgan, Christian A Hübner, John Christodoulou, Lesley C Adès
GMPPA encodes the GDP-mannose pyrophosphorylase A protein (GMPPA). The function of GMPPA is not well defined, however it is a homolog of GMPPB which catalyzes the reaction that converts mannose-1-phosphate and guanosine-5'-triphosphate to GDP-mannose. Previously, biallelic mutations in GMPPA were reported to cause a disorder characterized by achalasia, alacrima, neurological deficits, and intellectual disability. In this study, we report a female proband with achalasia, alacrima, hypohydrosis, apparent intellectual disability, seizures, microcephaly, esotropia, and craniofacial dysmorphism...
June 2, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28568312/autoimmune-comorbidity-in-achalasia-patients
#15
Fernanda Romero-Hernández, Janette Furuzawa-Carballeda, Gabriela Hernández-Molina, Edgar Alejandro-Medrano, Carlos A Núñez-Álvarez, Diego F Hernández-Ramírez, Daniel Azamar-Llamas, Elizabeth Olivares-Martínez, Blanca Breña, Axel Palacios, Miguel A Valdovinos, Enrique Coss-Adame, Bárbara Ramos-Ávalos, Samuel Torres-Landa, Axel A Hernández-Ávila, Athenea Flores-Nájera, Gonzalo Torres-Villalobos
BACKGROUND: Idiopathic achalasia is a rare esophageal motor disorder. The disease state manifests local and systemic inflammation, and it appears that an autoimmune component and specific autoantibodies participate in the pathogenesis. AIM: To determine the prevalence of autoimmune and chronic inflammatory diseases in patients with achalasia and compare the results with those from patients with gastroesophageal reflux disease (GERD). METHODS: It was a cross-sectional and included 114 patients with idiopathic achalasia and 114 age-and sex-matched control patients with GERD...
May 31, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28566891/ling-classification-describes-endoscopic-progressive-process-of-achalasia-and-successful-peroral-endoscopy-myotomy-prevents-endoscopic-progression-of-achalasia
#16
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
#17
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
#18
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
#19
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/28547866/economic-evaluation-of-the-randomized-european-achalasia-trial-comparing-pneumodilation-with-laparoscopic-heller-myotomy
#20
A Moonen, O Busch, M Costantini, E Finotti, J Tack, R Salvador, G Boeckxstaens, G Zaninotto
BACKGROUND: A recent multicenter randomized trial in achalasia patients has shown that pneumatic dilation resulted in equivalent relief of symptoms compared to laparoscopic Heller myotomy. Additionally, the cost of each treatment should be also taken in consideration. Therefore, the aim of the present study was to perform an economic analysis of the European achalasia trial. METHODS: Patients with newly diagnosed achalasia were enrolled from to 2003 to 2008 in 14 centers in five European countries and were randomly assigned to either pneumatic dilation (PD) or laparoscopic Heller (LHM)...
May 25, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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