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https://www.readbyqxmd.com/read/29342262/preliminary-study-of-1940-nm-thulium-laser-usage-in-peroral-endoscopic-myotomy-for-achalasia
#1
J Liu, Y Jiao, Y Niu, L Yu, M Ji, S Zhang
Esophageal achalasia is a type of motility disorder characterized by incomplete relaxation of lower esophageal sphincter (LES) and absence of esophageal peristalsis. Peroral endoscopic myotomy (POEM) is a new treatment option for achalasia that is less invasive, more effective, and safe as compared to surgery. High-frequency electrotome is commonly used in POEM, but takes longer time to make the tunnel in the esophagus and causes many complications. The thulium laser decreases the risk of bleeding and perforation in endoscopy but has not been reported in digestive diseases, especially in POEM...
January 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29340927/achalasia-cardia-in-a-young-infant
#2
V Poornachand, K Kumarasamy, S P Karamath, V Seenivasan, Sumathi Bavanandam, Nirmala Dheivamani
Achalasia cardia is an esophageal motility disorder rarely reported in children and more so in young infants. Common clinical presentations include vomiting, dysphagia, regurgitation, recurrent pulmonary aspiration and failure to thrive. Diagnosis is made by barium swallow study and esophageal manometry, which is the gold standard test. Pharmocological management and endotherapy often fails and results in recurrence of symptoms. Laparoscopic Hellers myotomy, with or without anti-reflux procedure is the standard treatment of choice for children...
January 17, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29338493/challenges-of-peroral-endoscopic-myotomy-in-the-treatment-of-distal-esophageal-spasm
#3
Fraukje Anna-Marie Ponds, André J P M Smout, Paul Fockens, Albert J Bredenoord
OBJECTIVE: Distal esophageal spasm (DES) is a rare motility disorder characterized by premature and rapidly propagated contractions of the distal esophagus. Treatment options are limited and often poorly effective. Peroral endoscopic myotomy (POEM) seems an effective and attractive new treatment option for DES. In this case report we describe some of the difficulties that could arise. MATERIALS AND METHODS: A 84-year old man with therapy-refractory DES and complaints of severe dysphagia and chest pain underwent a POEM procedure under general anesthesia...
January 17, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29336919/achalasia-subtype-differences-based-on-clinical-symptoms-radiographic-findings-and-stasis-scores
#4
EDITORIAL
M A Valdovinos Díaz
No abstract text is available yet for this article.
January 11, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29334914/-crying-without-tears-as-an-early-diagnostic-sign-post-of-triple-a-allgrove-syndrome-two-case-reports
#5
Daniel Tibussek, Sujal Ghosh, Angela Huebner, Joerg Schaper, Ertan Mayatepek, Katrin Koehler
BACKGROUND: Triple A syndrome (or Allgrove syndrome) is a rare autosomal recessive disorder characterized by alacrima, achalasia, adrenal insufficiency and autonomic/neurological abnormalities. The majority of cases are caused by mutations in the AAAS gene located on chromosome 12q13. However, the clinical picture as well as genetic testing may be complex since symptomatology is variable and mutations cannot be identified in all clinically diagnosed patients. We present two unrelated patients with triple-A syndrome illustrating the importance of alacrima as an early clinical sign...
January 15, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29321968/achalasia-with-massive-oesophageal-dilation-causing-tracheomalacia-and-asthma-symptoms
#6
Ana Gomez-Larrauri, Simon Galloway, Rob Niven
Achalasia is an uncommon oesophageal motor disorder characterized by failure of relaxation of the lower oesophageal sphincter and muscle hypertrophy, resulting in a loss of peristalsis and a dilated oesophagus. Gastrointestinal symptoms are invariably present in all cases of achalasia observed in adults. We report a case of a 34 year-old female patient with long standing history of asthma-like symptoms, labelled as uncontrolled and steroid resistant asthma with no gastrointestinal manifestations. Thoracic CT scan revealed a massive oesophagus due to achalasia, which caused severe tracheomalacia as a result of tracheal compression...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29319024/what-to-do-when-heller-s-myotomy-fails-pneumatic-dilatation-laparoscopic-remyotomy-or-peroral-endoscopic-myotomy-a-systematic-review
#7
REVIEW
Sonia Fernández-Ananín, Arnulfo F Fernández, Carmen Balagué, David Sacoto, Eduardo Maria Targarona
BACKGROUND: Surgical treatment of achalasia fails in 10%-20% of patients. The most frequent responsible cause is the performance of an incomplete myotomy at primary surgery. The treatment when the failure happens is not well defined. In this study, we review and evaluate the possible treatments to be carried out when surgical myotomy fails. We define its benefits and results, with the purpose of defining a therapeutic algorithm. MATERIALS AND METHODS: The systematic review was performed following the guidelines established by the Meta-analysis of Observational Studies in Epidemiology statement...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29319022/thoracoscopic-oesophagectomy-for-end-stage-achalasia
#8
Vaibhav Kumar Varshney, Subhash Chandra Soni, Manju Kumari, Pawan Kumar Garg, Ashok Puranik
Achalasia cardia is an oesophageal motility disorder characterised by aperistalsis and failure of relaxation of the lower oesophageal sphincter. The management is predominantly palliative with focus on addressing the sphincter that involves either pneumatic dilatation or Heller myotomy which relieves dysphagia in the majority of the cases. End-stage achalasia (ESA) is characterised by failed myotomy, massively dilated and tortuous oesophagus with nutritional deterioration due to progressive dysphagia and vomiting...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29316591/minimally-invasive-myotomy-percutaneous-laparoscopic-surgical-approach-for-achalasia
#9
Lavinia Alessandra Barbieri, Davide Bona, Alberto Aiolfi, Giancarlo Micheletto, Marta Cavalli, Francesca Lombardo, Piero Giovanni Bruni, Giampiero Campanelli
The laparoscopic approach of the upper gastrointestinal tract is considered the gold standard for the treatment of functional benign esophageal disorders since 1990. In recent years, many efforts have been made to minimize the abdominal wall's trauma to reduce postoperative pain and to obtain a prompt return to daily activities, as well as improve cosmetic results of surgery. The progressive development of novel surgical devices has allowed for the introduction of new minimally-invasive surgical techniques...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29315993/evaluating-the-reliability-and-construct-validity-of-the-eckardt-symptom-score-as-a-measure-of-achalasia-severity
#10
T H Taft, D A Carlson, J Triggs, J Craft, K Starkey, R Yadlapati, D Gregory, J E Pandolfino
BACKGROUND: Achalasia is a disease of mechanical esophageal dysfunction characterized by dysphagia, chest pain, regurgitation, and malnutrition. The Eckardt symptom score (ESS) is the gold standard self-report assessment tool. Current guidelines outline a three-step approach to patient reported outcomes measure design. Developed prior to these policies, the ESS has not undergone rigorous testing of its reliability and validity. METHODS: Adult achalasia patients retrospectively identified via a patient registry were grouped based on treatment history...
January 8, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29312877/diagnostic-contribution-of-magnetic-resonance-imaging-in-an-atypical-presentation-of-motor-neuron-disease
#11
Lorenzo Ugga, Cinzia Coppola, Sirio Cocozza, Dario Saracino, Ferdinando Caranci, Francesco Tuccillo, Elisabetta Signoriello, Sara Casertano, Giuseppe Di Iorio, Enrico Tedeschi
Motor neuron disease (MND) is a neurodegenerative disease determining progressive and relentless motor deterioration involving both upper and lower motor neurons (UMN and LMN); several variants at onset are described. Here we describe a case of MND presenting as pure spastic monoparesis in which magnetic resonance imaging (MRI) gave a substantial contribution in confirming the diagnosis and assessing the severity of UMN involvement. An isolated pyramidal syndrome, with complete absence of LMN signs, is a rare phenotype in the context of MND (less than 4% of total cases), especially if restricted to only one limb...
December 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29288508/open-peroral-endoscopic-myotomy-for-achalasia-with-failed-heller-myotomy
#12
Wei Liu, Chun-Cheng Wu, Bing Hu
In May 2017, a 55-year-old man was referred to our endoscopy center because of dysphagia and chest pain. The patient with a history of failed Heller myotomy was diagnosed as a recurrence of achalasia (type II) with an Eckardt score of 13. Selective myotomy was achieved by peroral endoscopic myotomy without a submucosal tunnel for this case. We describe this technique as open peroral endoscopic myotomy(O-POEM) (Fig 1, 2). This article is protected by copyright. All rights reserved.
December 29, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29261823/association-of-surgical-volume-with-perioperative-outcomes-for-esophagomyotomy-for-esophageal-achalasia
#13
Francisco Schlottmann, Paula D Strassle, Marco G Patti
No abstract text is available yet for this article.
December 20, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29241847/recurrent-symptoms-after-per-oral-endoscopic-myotomy-in%C3%A2-achalasia-redo-dilate-or-operate-a-call-for-a%C3%A2-tailored%C3%A2-approach
#14
EDITORIAL
Ming-Ming Xu, Michel Kahaleh
No abstract text is available yet for this article.
January 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29237697/triple-a-syndrome-a-wide-spectrum-of-adrenal-dysfunction
#15
Florence Roucher-Boulez, Aude Brac de la Perrière, Aude Jacquez, Delphine Chau, Laurence Guignat, Christophe Vial, Yves Morel, Marc Nicolino, Gerald Raverot, Michel Pugeat
Objective: Triple-A or Allgrove syndrome is an autosomal recessive disorder due to mutations in the AAAS gene which encodes a nucleoporin named ALADIN. It is characterized by a classical clinical triad: Alacrima, Achalasia and Adrenal Insufficiency, the canonic symptoms that are associated with progressive peripheral neuropathy. Only a few cohorts have been reported. The objective of the present study was to characterize the various spectra of adrenal function in Triple-A patients. Methods: A retrospective clinical and biological monitoring of 14 patients (10 families) was done in a single multidisciplinary French center...
December 13, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29231090/esophageal-dysmotility-in-patients-following-total-laryngectomy
#16
Teng Zhang, Julia Maclean, Michal Szczesniak, Paul P Bertrand, Harry Quon, Raymond K Tsang, Peter I Wu, Peter Graham, Ian J Cook
Objectives Dysphagia is common in total laryngectomees, with some symptoms suggesting esophageal dysmotility. Tracheoesophageal (TE) phonation requires effective esophagopharyngeal air passage. Hence, esophageal dysmotility may affect deglutition or TE phonation. This study aimed to determine (1) the characteristics of esophageal dysmotility in laryngectomees, (2) whether clinical history is sensitive in detecting esophageal dysmotility, and (3) the relationship between esophageal dysmotility and TE prosthesis dysfunction...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29228523/advanced-therapeutic-gastrointestinal-endoscopy-in-children-today-and-tomorrow
#17
Zaheer Nabi, Duvvur Nageshwar Reddy
Gastrointestinal (GI) endoscopy plays an indispensable role in the diagnosis and management of various pediatric GI disorders. While the pace of development of pediatric GI endoscopy has increased over the years, it remains sluggish compared to the advancements in GI endoscopic interventions available in adults. The predominant reasons that explain this observation include lack of formal training courses in advanced pediatric GI interventions, economic constraints in establishing a pediatric endoscopy unit, and unavailability of pediatric-specific devices and accessories...
December 12, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29226475/a-double-scope-method-for-creating-a-straight-submucosal-tunnel-during-peroral-endoscopic-myotomy
#18
Hironari Shiwaku, Kanefumi Yamashita, Suguru Hasegawa
Peroral endoscopic myotomy (POEM) is a revolutionary treatment for achalasia.1-3 It involves creating a submucosal tunnel directly to the stomach side; theoretically, a straight tunnel can be obtained by creating it perpendicular to the inner annulus muscle. Clinically, this is not always easy; therefore, we introduced a new method for controlling the submucosal tunnel direction in which a small-diameter endoscope is inserted along with the main endoscope. This allows us to check the illumination of the main scope in the submucosal layer, which can be particularly useful when treating a sigmoid-type anomaly with a highly flexed esophagus...
December 11, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29218664/cost-effectiveness-of-per-oral-endoscopic-myotomy-relative-to-laparoscopic-heller-myotomy-for-the-treatment-of-achalasia
#19
Erin K Greenleaf, Joshua S Winder, Christopher S Hollenbeak, Randy S Haluck, Abraham Mathew, Eric M Pauli
BACKGROUND: Per oral endoscopic myotomy (POEM) has recently emerged as a viable option relative to the classic approach of laparoscopic Heller myotomy (LHM) for the treatment of esophageal achalasia. In this cost-utility analysis of POEM and LHM, we hypothesized that POEM would be cost-effective relative to LHM. METHODS: A stochastic cost-utility analysis of treatment for achalasia was performed to determine the cost-effectiveness of POEM relative to LHM. Costs were estimated from the provider perspective and obtained from our institution's cost-accounting database...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29215957/peroral-endoscopic-myotomy-with-endoflip-and-double-endoscope-novel-techniques-for-achalasia-in-pediatric-population
#20
Fanny Yeung, Ian Y H Wong, Patrick H Y Chung, Kenneth K Y Wong, Simon Y K Law, Paul K H Tam
BACKGROUND: Experience of peroral endoscopic myotomy (POEM) for treatment of achalasia in pediatric population is limited with varying techniques in different centers. The accurate extent of submucosal tunneling into the gastric cardia and the adequacy of myotomy are the important determining factors to success of POEM. A majority of studies in pediatric population have described using submucosal dye injection for assessing the adequacy of myotomy, however, this is a rather crude and inaccurate method...
December 7, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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