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https://www.readbyqxmd.com/read/28924729/dor-vs-toupet-fundoplication-after-laparoscopic-heller-myotomy-long-term-randomized-controlled-trial-evaluated-by-high-resolution-manometry
#1
Gonzalo Torres-Villalobos, Enrique Coss-Adame, Janette Furuzawa-Carballeda, Fernanda Romero-Hernández, Blanca Blancas-Breña, Samuel Torres-Landa, Axel Palacios-Ramírez, Edgar Alejandro-Medrano, Axel Hernández-Ávila, Athenea Flores-Najera, Lourdes Margarita Ávila Escobedo, Cecilia Ramírez Angulo, Angélica Rodríguez-Garcés, Miguel Ángel Valdovinos
BACKGROUND: Laparoscopic Heller myotomy (LHM) with partial fundoplication is an effective treatment for achalasia. However, the type of fundoplication is still a subject of debate. AIM: The aim of the study is to identify which partial fundoplication leads to better control of acid exposure, manometric parameters, and symptoms scores. METHODS: A randomized controlled trial was performed to compare Dor vs Toupet fundoplication after LHM. The preoperative diagnosis was made by high-resolution manometry (HRM), upper endoscopy, and barium esophagogram...
September 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28919276/-focus-on-achalasia
#2
Marie-Anne Guillaumot, Maximilien Barret, Sarah Leblanc, Mahaut Leconte, Bertrand Dousset, Ammar Oudjit, Frédéric Prat, Stanislas Chaussade
The pathophysiology of achalasia is largely unknown, and involves the destruction of ganglion cell in the esophageal myenteric plexus. High-resolution esophageal manometry is the key investigation. Endoscopic pneumodilatation and laparoscopic Heller myotomy have comparable short-term success rates, around 90%. The main complication after pneumodilatation is esophageal perforation, occurring in about 1% of cases. Peroral endoscopic myotomy is a promising treatment modality, however with frequent post-procedural gastroesophageal reflux...
September 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28916889/teaching-peroral-endoscopic-myotomy-poem-to-surgeons-in-practice-an-into-the-fire-pre-post-test-curriculum
#3
Tomokazu Kishiki, Brittany Lapin, Chi Wang, Brandon Jonson, Lava Patel, Matthew Zapf, Matthew Gitelis, Maria A Cassera, Lee L Swanström, Michael B Ujiki
INTRODUCTION: With the increasing adoption of peroral endoscopic myotomy (POEM) as a first-line therapy for achalasia as well as a growing list of other indications, it is apparent that there is a need for effective training methods for both endoscopists in training and those already in practice. We present a hands-on-focused with pre- and post-testing methodology to teach these skills. METHODS: Six POEM courses were taught by 11 experienced POEM endoscopists at two independent simulation laboratories...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28898921/long-term-quality-of-life-after-peroral-endoscopic-myotomy-remains-compromised-in-patients-with-achalasia-type-iii
#4
Oscar V Hernández Mondragón, Marina A González Martinez, Juan M Blancas Valencia, Maria L Hernandez Reyes, Omar M Solórzano Pineda, Gerardo Blanco Velasco
Background and study aims Peroral endoscopic myotomy (POEM) is an excellent endoscopic treatment for achalasia. Clinical and manometric parameters are used for evaluation and follow-up. However, clinical success does not guarantee high quality of life (QoL) scores, generating doubts about their direct relationship. We aimed to evaluate QoL scores before and after POEM at medium and long term, to evaluate differences between achalasia subtypes and find which factors related to low QoL scores. Patients and methods Achalasia-confirmed patients undergoing POEM between February 2012 and November 2016...
September 12, 2017: Endoscopy
https://www.readbyqxmd.com/read/28884499/per-oral-endoscopic-myotomy-in-achalasia-and-large-epiphrenic-diverticulum-a-case-study
#5
Michal Demeter, Peter Bánovčin, Martin Ďuriček, Rastislav Kunda, Rudolf Hyrdel
Symptomatic epiphrenic diverticula are mostly treated surgically with laparoscopic diverticulectomy, myotomy and anterior fundoplication. However, in case the patient does not agree with surgical therapy or is contraindicated there are limited ways of alternative treatment. We present a case report of a 72-year-old female patient with severe dysphagia, regurgitation, paroxysmal cough, weight loss and malnutrition who was diagnosed with achalasia and large epiphrenic diverticulum. She did not give consent with surgical treatment that was proposed...
September 7, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28881885/igg4-related-disease-involving-the-esophagus-a-clinicopathological-study
#6
I Obiorah, A Hussain, C Palese, N Azumi, S Benjamin, M Ozdemirli
Immunoglobulin G4 (IgG4)-related disease is a recently coined systemic disease characterized by specific histopathologic findings of an intense lymphoplasmacytic infiltrate, storiform fibrosis, and obliterative phlebitis in the presence of predominant IgG4-positive plasma cells. Although IgG4-related disease has been described in many organs, involvement of the esophagus is very rare. In this study, we describe the clinicopathologic characteristics of eight patients with IgG4-related esophagitis. We evaluated chronic esophagitis specimens with lymphoplasmacytic infiltrate obtained over the past 6 years (from January 2011 to February 2017) using a chart review, pathologic examination, and IgG4 immunohistochemical staining...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28881880/trends-in-diagnoses-after-implementation-of-the-chicago-classification-for-esophageal-motility-disorders-v3-0-for-high-resolution-manometry-studies
#7
P Laing, A P Bress, J Fang, K Peterson, D G Adler, A J Gawron
To determine trends in the diagnostic distribution of esophageal motility disorders after implementation of the Chicago Classification Version 3.0 (CC V3.0) for interpretation of high-resolution manometry (HRM) studies compared to non-Chicago Classification criteria. Retrospective trends analysis of patients with an HRM study conducted at a single center from January 1, 2013 to September 30, 2015. The implementation of the CC V3.0 for manometry interpretation occurred in September 2014. Patient charts were manually reviewed for data collection including demographics and HRM diagnoses...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28881879/spectrum-of-esophageal-dysmotility-in-systemic-sclerosis-on-high-resolution-esophageal-manometry-as-defined-by-chicago-classification
#8
N Aggarwal, R Lopez, S Gabbard, N Wadhwa, P Devaki, P N Thota
The classic manometric findings in systemic sclerosis are aperistalsis of the esophageal body with hypotensive lower esophageal sphincter. These changes contribute to gastroesophageal reflux disease in these patients. With widespread use of high-resolution esophageal manometry, diverse abnormalities are seen. The aim of this study is to characterize esophageal dysmotility in patients with systemic sclerosis undergoing high-resolution esophageal manometry and compare demographic features and diagnostic test results among patients with varying degrees of esophageal dysmotility...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28877100/abdominal-pain-and-vomiting
#9
Joshua McCambridge, Peter Wang
Abdominal ultrasound of a 28-year-old man with chronic abdominal pain and vomiting demonstrates a dilated aperistaltic distal esophagus, which was confirmed on follow-up esophagram as achalasia. The 2 main types of achalasia are primary and secondary. Primary achalasia occurs with the loss of postganglionic neurons resulting in failed distal esophageal relaxation. Secondary achalasia is esophageal narrowing due to nondenervation causes. The diagnosis of achalasia is typically made with manometry and barium esophagram...
September 4, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28867969/an-overview-of-achalasia-and-its-subtypes
#10
Dhyanesh A Patel, Brian M Lappas, Michael F Vaezi
Achalasia is one of the most studied esophageal motility disorders. However, the pathophysiology and reasons that patients develop achalasia are still unclear. Patients often present with dysphagia to solids and liquids, regurgitation, and varying degrees of weight loss. There is significant latency prior to diagnosis, which can have nutritional implications. The diagnosis is suspected based on clinical history and confirmed by esophageal high-resolution manometry testing. Esophagogastroduodenoscopy is necessary to rule out potential malignancy that can mimic achalasia...
July 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28867967/achalasia
#11
Gary R Lichtenstein
No abstract text is available yet for this article.
July 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28866876/understanding-the-chicago-classification-from-tracings-to-patients
#12
REVIEW
Francisco Schlottmann, Fernando A Herbella, Marco G Patti
Current parameters of the Chicago classification include assessment of the esophageal body (contraction vigour and peristalsis), lower esophageal sphincter relaxation pressure, and intra-bolus pressure pattern. Esophageal disorders include achalasia, esophagogastric junction outflow obstruction, major disorders of peristalsis, and minor disorders of peristalsis. Sub-classification of achalasia in types I, II, and III seems to be useful to predict outcomes and choose the optimal treatment approach. The real clinical significance of other new parameters and disorders is still under investigation...
September 1, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/28859394/esophageal-achalasia-a-risk-factor-for-carcinoma-a-systematic-review-and-meta-analysis
#13
F Tustumi, W M Bernardo, J R M da Rocha, S Szachnowicz, F C Seguro, E T Bianchi, R A A Sallum, I Cecconello
Achalasia of the cardia is associated with an increased risk of esophageal carcinoma. The real burden of achalasia at the malignancy genesis is still a controversial issue. Therefore, there are no generally accepted recommendations on follow-up evaluation for achalasia patients. This study aims to estimate the risk of esophageal adenocarcinoma and squamous cell carcinoma in achalasia patients. We searched for association between carcinoma and esophageal achalasia in databases up to January 2017 to perform a systematic review and meta-analysis...
October 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28859393/open-peroral-endoscopic-myotomy-o-poem-for-the-treatment-of-achalasia
#14
W Liu, H-Z Zeng, H-L Chen, C-C Wu, L-S Ye, B Hu
With the development of endoscopic interventions and inspired by the success of peroral endoscopic myotomy (POEM) for the treatment of achalasia, we investigated an old method of direct peroral endoscopic myotomy without a submucosal tunnel for the treatment of achalasia, which we call open peroral endoscopic myotomy (O-POEM). In this study, Clinical success was achieved in the patient after O-POEM. A reduction of LES pressure, Eckardt score, and a timed barium esophagogram were observed during follow-up. There were no severe complications and no recurrences during two months of follow-up...
October 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28859391/esophagogastric-junction-outflow-obstruction-is-often-associated-with-coexistent-abnormal-esophageal-body-motility-and-abnormal-bolus-transit
#15
E Zheng, R M Gideon, J Sloan, P O Katz
Currently, the diagnosis of esophageal motility disorders is in part based upon a hierarchical algorithm in which abnormalities of the esophagogastric junction (EGJ) is prioritized. An important metric in evaluating the EGJ is the integrated relaxation pressure (IRP). Patients who do not have achalasia but are found to have an elevated IRP are diagnosed with EGJ outflow obstruction. It has been our observation that a subset of these patients also has a second named motility disorder and may also have abnormal bolus transit...
October 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28843659/laparoscopic-graduated-cardiomyotomy-with-anterior-fundoplication-as-treatment-for-achalasia-experience-of-48-cases
#16
A Etchegaray-Dondé, G Rodríguez-Espínola, F Higuera-Hidalgo, V Ortiz-Higareda, O Chapa-Azuela, A Etchegaray-Solana
INTRODUCTION AND AIMS: At the Upper Gastrointestinal Tract Clinic of the Hospital General de Mexico, achalasia treatment has been standarized through strictly graduated cardiomyotomy. This procedure guarantees a complete myotomy for the satisfactory resolution of dysphagia, a characteristic symptom of achalasia. To ensure the inclusion of the entire lower esophageal sphincter, an 8cm Penrose drain is placed at the surgical site 6cm above the gastroesophageal junction and 2cm in a caudal direction, for accurate laparoscopic measuring...
August 23, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28840505/anesthesia-in-per-oral-endoscopic-myotomy-a-large-tertiary-care-centre-experience
#17
Santosh Darisetty, Zaheer Nabi, Mohan Ramchandani, Radhika Chavan, Rama Kotla, D Nageshwar Reddy
BACKGROUND AND OBJECTIVES: Per-oral endoscopic myotomy (POEM) is safe and efficacious for the management of achalasia cardia (AC). POEM is usually performed under general anesthesia in an endoscopy suite or operating theatre. The current study was conducted with the aim to analyse anesthetic management of patients with AC who underwent POEM at our institution. METHODS: We retrospectively analysed the data of patients with AC who underwent POEM at our institution from January 2013 to September 2016...
August 24, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28839899/poem-and-the-management-of-achalasia
#18
Matthew Banks, Rami Sweis
Achalasia is a rare oesophageal motility disorder predominantly causing dysphagia and regurgitation of food and fluids. Diagnosis is made typically after a combination of tests including endoscopy, barium swallow and oesophageal manometry. The advent of high-resolution manometry has led to the Chicago Classification which divided achalasia into three types. This improved the understanding of presentation, prognosis and might also help tailor therapy. Botulinum toxin has been shown to have good, but short-term efficacy...
April 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28836740/incidence-and-costs-of-achalasia-in-the-netherlands
#19
F B van Hoeij, F A Ponds, A J Smout, A J Bredenoord
BACKGROUND: Recent reports show increasing incidence of achalasia in some populations. The aim of this study was to estimate incidence, prevalence, and healthcare costs of achalasia in a large cohort in The Netherlands. METHODS: Data were obtained from the largest Dutch healthcare insurance company (±4.4 million insured). Adult achalasia patients were identified between 2006 and 2014 when having an achalasia diagnosis code registered. A total of 907 achalasia patients were identified and included in our database, along with 9068 control patients (non-achalasia patients), matched by age and gender...
August 24, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28827050/initial-experience-with-peroral-endoscopic-myotomy-for-treatment-of-achalasia-in-children
#20
William C Kethman, Chad M Thorson, Tiffany J Sinclair, William E Berquist, Stephanie D Chao, James K Wall
BACKGROUND: Achalasia is a primary esophageal motility disorder characterized by aperistalsis of the esophagus and failed relaxation of the lower esophageal sphincter that presents rarely in childhood. The peroral endoscopic myotomy (POEM) procedure is an emerging treatment for achalasia in adults that has recently been introduced into pediatric surgical practice. METHODS: This is a prospective case series of all children referred to Stanford University Lucile Packard Children's Hospital with manometry-confirmed achalasia who underwent a POEM procedure from 2014 to 2016...
August 9, 2017: Journal of Pediatric Surgery
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