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https://www.readbyqxmd.com/read/28052278/diagnosis-and-treatment-strategy-of-achalasia-subtypes-and-esophagogastric-junction-outflow-obstruction-based-on-high-resolution-manometry
#1
Eikichi Ihara, Kazumasa Muta, Keita Fukaura, Kazuhiko Nakamura
BACKGROUND: Based on Chicago Classification version 3.0, the disorders of esophagogastric junction outflow obstruction (EGJOO) include achalasia (types I, II and III) and EGJOO. Although no curative treatments are currently available for the treatment of the disorders of EGJOO, medical treatments, endoscopic pneumatic dilation (PD), laparoscopic Heller myotomy (LHM), and per-oral endoscopic myotomy (POEM) are usually the sought-after modes of treatment. Since the etiology and pathogenesis might vary depending on the types of EGJOO disorders, treatment strategies should be considered based on those subtypes...
2017: Digestion
https://www.readbyqxmd.com/read/27955962/pneumatic-dilation-for-functional-helix-stenosis-after-sleeve-gastrectomy-long-term-follow-up-with-videos
#2
Gianfranco Donatelli, Jean-Loup Dumont, Guillame Pourcher, Hadrien Tranchart, Thierry Tuszynski, Ibrahim Dagher, Jean-Marc Catheline, Renaud Chiche, Jean-Pierre Marmuse, Stavros Dritsas, Bertrand-Marie Vergeau, Bruno Meduri
BACKGROUND: A large number of patients who undergo laparoscopic sleeve gastrectomy present with surgical complications. Stenosis, in particular, occurs in .7%-4% of cases. OBJECTIVES: To report our experience, results, and long-term follow-up after pneumatic dilation of late functional helix stenosis after laparoscopic sleeve gastrectomy. SETTING: Multicenter study led by an endoscopic tertiary referral center. METHODS: Thirty-five patients were dilated initially at 30 mm...
September 28, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27928603/-laparoscopic-heller-myotomy-after-failed-poem-and-multiple-balloon-dilatations-better-late-than-never
#3
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/27925255/the-course-of-achalasia-one-to-four-decades-after-initial-treatment
#4
T Sawas, K Ravi, D M Geno, F Enders, K Pierce, D Wigle, D A Katzka
BACKGROUND: Most follow-up studies of achalasia are limited to <5 years. AIMS: To study the long-term efficacy of pneumatic dilation (PD) and myotomy in achalasia at least 10 years after treatment. METHODS: We performed a retrospective cohort study of achalasia patients with >10 years follow-up after initial myotomy or pneumatic dilation. Symptom recurrence which required repeat dilation or surgery was compared between pneumatic dilation and myotomy...
December 7, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27901639/results-of-laparoscopic-heller-s-myotomy-for-achalasia-in-children-a-systematic-review-of-the-literature
#5
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/27878898/feasibility-and-safety-of-peroral-endoscopic-myotomy-for-achalasia-after-failed-endoscopic-interventions
#6
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/27875853/use-of-endoscopic-septotomy-for-the-treatment-of-late-staple-line-leaks-after-laparoscopic-sleeve-gastrectomy
#7
Mati Shnell, Nathan Gluck, Subhi Abu-Abeid, Erwin Santo, Sigal Fishman
Background Staple-line leak following laparoscopic sleeve gastrectomy is a dire adverse event. While the treatment of acute and early leaks is well established, there is still dispute regarding late and chronic leaks. We describe an endoscopic approach combining septotomy and sleeve stricture dilation for treating late/chronic leaks. Methods Ten consecutive patients with late/chronic proximal leaks were treated at our center. The septum separating the sleeve lumen from the perigastric cavity was progressively dissected over several sessions and the downstream stricture was pneumatically dilated...
January 2017: Endoscopy
https://www.readbyqxmd.com/read/27865290/pneumatic-dilation-of-the-lower-esophageal-sphincter-can-now-be-successfully-performed-without-morbidity
#8
Yi Jia, Marco Bustamante, Sharareh Moraveji, Richard W McCallum
BACKGROUND: Patients with dysphagia may be diagnosed with impaired lower esophageal sphincter (LES) relaxation and treated with pneumatic dilation (PD), stretching and tearing LES muscle fibers. Esophageal perforation has been reported to be as high as 10%. We conducted a retrospective study to evaluate the perforation rate of PD when used for impaired relaxation of the LES using current techniques. METHODS: A chart review was conducted to identify patients referred for esophageal manometry by high-resolution manometry and later received PD from January 2013 to April 2016...
November 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27818585/update-on-the-endoscopic-treatments-for-achalasia
#9
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/27754816/achalasia-2016-treatment-alternatives
#10
Fernando A M Herbella, Eduardo G H Moura, Marco G Patti
The treatment for achalasia changed dramatically after the introduction of minimally invasive surgery. Since 1991, laparoscopic Heller myotomy (LHM) has replaced pneumatic dilatation (PD) as the primary form of treatment in many centers. Over time, PD became safer, and eventually endoscopic experts were able to perform an endoscopic myotomy via a per oral endoscopic myotomy (POEM). This article reviews the advantages and disadvantages of each technique. Ultimately, the best outcomes are obtained by a multidisciplinary team that can tailor a specific treatment to each individual patient...
January 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27711096/retrograde-intrarenal-surgery-rirs-regular-and-small-sized-percutaneous-nephrolithotomy-pcnl-in-daily-practice-european-association-of-urology-section-of-urolithiasis-eulis-survey
#11
Stefano Paolo Zanetti, Luca Boeri, Michele Catellani, Andrea Gallioli, Alberto Trinchieri, Kemal Sarica, Emanuele Montanari
OBJECTIVE: A wide selection of both anterograde and retrograde mini-invasive procedures exist for stones' treatment. The 2016 European Association of Urology (EAU) guidelines still don't univocally define a best option. Our purpose is to give an overview on some European Stone Centers' customs and to compare real life clinical practice with statements of opinion leaders and Guidelines. MATERIALS AND METHODS: In 2015 we performed a survey in 3 step about the spread of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) techniques among EAU Section of Urolithiasis (EULIS) members...
October 5, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/27698386/high-resolution-impedance-manometry-metrics-of-the-esophagogastric-junction-for-the-assessment-of-treatment-response-in-achalasia
#12
Dustin A Carlson, Zhiyue Lin, Peter J Kahrilas, Joel Sternbach, Eric S Hungness, Nathaniel J Soper, Michelle Balla, Zoe Listernick, Michael Tye, Katherine Ritter, Jenna Craft, Jody D Ciolino, John E Pandolfino
OBJECTIVES: We aimed to evaluate the value of novel high-resolution impedance manometry (HRIM) metrics, bolus flow time (BFT), and esophagogastric junction (EGJ) contractile integral (CI), as well as EGJ pressure (EGJP) and the integrated relaxation pressure (IRP), as indicators of treatment response in achalasia. METHODS: We prospectively evaluated 75 patients (ages 19-81, 32 female) with achalasia during follow-up after pneumatic dilation or myotomy with Eckardt score (ES), timed-barium esophagram (TBE), and HRIM...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27696376/evaluation-of-outcome-after-cardiomyotomy-for-achalasia-using-the-chicago-classification
#13
P W Hamer, R H Holloway, R Heddle, P G Devitt, G Kiroff, C Burgstad, S K Thompson
BACKGROUND: Achalasia can be subdivided into manometric subtypes according to the Chicago classification. These subtypes are proposed to predict outcome after treatment. This hypothesis was tested using a database of patients who underwent laparoscopic Heller's cardiomyotomy with anterior fundoplication. METHODS: All patients who underwent Heller's cardiomyotomy for achalasia between June 1993 and March 2015 were identified from an institutional database. Manometry tracings were retrieved and re-reported according the Chicago classification...
December 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27663714/long-term-outcomes-of-per-oral-endoscopic-myotomy-in-patients-with-achalasia-with-a-minimum-follow-up-of-2-years-an%C3%A2-international-multicenter-study
#14
Saowanee Ngamruengphong, Haruhiro Inoue, Philip Wai-Yan Chiu, Hon Chi Yip, Amol Bapaye, Michael Ujiki, Lava Patel, Pankaj N Desai, Bu Hayee, Amyn Haji, Vivien Wai-Yin Wong, Silvana Perretta, Shivangi Dorwat, Mathieu Pioche, Sabine Roman, Jérôme Rivory, François Mion, Thierry Ponchon, Aurélien Garros, Jun Nakamura, Yoshitaka Hata, Valerio Balassone, Manabu Onimaru, Gulara Hajiyeva, Amr Ismail, Yen-I Chen, Majidah Bukhari, Yamile Haito-Chavez, Vivek Kumbhari, Roberta Maselli, Alessandro Repici, Mouen A Khashab
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) has shown promising safety and efficacy in short-term studies. However, long-term follow-up data are very limited. The aims of this study were to assess (1) clinical outcome of patients with a minimum post-POEM follow-up of 2 years and (2) factors associated with long-term clinical failure after POEM. METHODS: A retrospective chart review was performed that included all consecutive patients with achalasia who underwent POEM with a minimum follow-up of 2 years at 10 tertiary-care centers...
September 20, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27649684/peroral-endoscopic-myotomy-versus-pneumatic-dilation-for-achalasia-in-patients-aged-%C3%A2-65-years
#15
Xuehong Wang, Yuyong Tan, Liang Lv, Hongyi Zhu, Yi Chu, Chenjie Li, Deliang Liu
BACKGROUND AND AIM: Both peroral endoscopic myotomy (POEM) and pneumatic dilation (PD) has proved to be effective for treating achalasia in patients aged ≥ 65 years. However little is known about the comparison between POEM and PD. The aim of the study was to compare the safety and efficacy of POEM and PD for the treatment of achalasia in these patients. METHODS: We retrospectively reviewed the medical records of patients aged 65 years-old or more who received POEM or PD for the treatment of achalasia at our hospital from January 2010 to December 2015, they were divided into the POEM group and the PD group...
October 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27619832/achalasia-specific-quality-of-life-after-pneumatic-dilation-or-laparoscopic-heller-myotomy-with-partial-fundoplication-a-multicenter-randomized-clinical-trial
#16
Caitlin C Chrystoja, Gail E Darling, Nicholas E Diamant, Paul P Kortan, George A Tomlinson, Wayne Deitel, Audrey Laporte, Julie Takata, David R Urbach
OBJECTIVES: Achalasia is a chronic, progressive, and incurable esophageal motility disease. There is clinical uncertainty about which treatment should be recommended as first-line therapy. Our objective was to evaluate the effectiveness of pneumatic dilation compared with laparoscopic Heller myotomy with partial fundoplication in improving achalasia-specific quality of life. METHODS: This was a prospective, multicenter, randomized trial at five academic hospitals in Canada...
November 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27583785/laser-lithotripsy-in-the-treatment-of-renal-stones-in-children-a-single-center-experience
#17
Predrag Ilic, Miroslav Djordjevic, Vladimir Kojovic, Slobodan Dzambasanovic
AIM: To evaluate the effectiveness and safety of laser lithotripsy in the treatment of renal stones in children in a single center. MATERIAL AND METHODS: We retrospectively analysed patients (n=36) who were treated with laser nephrolithotripsy (LL group) between 2011 and 2014. We compared those results with results of pneumatic nephrolithotripsy in patients (n=32) who were treated from 2007 to 2011 (PL group). The patients were evaluated in respect of gender, age, stone location, stone size, complications and stone-free rate...
July 22, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27580786/pneumatic-dilation-for-achalasia-obliterate-the-waist
#18
Puja S Elias, Donald Castell
No abstract text is available yet for this article.
September 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27571581/achalasia-from-diagnosis-to-management
#19
Michael F Vaezi, Valter N Felix, Roberto Penagini, Aurelio Mauro, Eduardo Guimarães Hourneaux de Moura, Leonardo Zorrón Cheng Tao Pu, Jan Martinek, Erwin Rieder
Achalasia is an esophageal motility disorder associated with abnormalities in peristalsis and lower esophageal sphincter (LES) relaxation. The etiology of the disease remains elusive. It is often misdiagnosed initially as gastroesophageal reflux disease. Patients with achalasia often complain of dysphagia to solids and liquids but may focus on regurgitation as the primary symptom, leading to the early misdiagnosis. Chest pain, weight loss, and occasional vomiting may be additional symptoms encountered in those with achalasia...
August 29, 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27534662/poem-is-a-cost-effective-procedure-cost-utility-analysis-of-endoscopic-and-surgical-treatment-options-in-the-management-of-achalasia
#20
Heidi J Miller, Ruel Neupane, Mojtaba Fayezizadeh, Arnab Majumder, Jeffrey M Marks
BACKGROUND: Achalasia is a rare motility disorder of the esophagus. Treatment is palliative with the goal of symptom remission and slowing the progression of the disease. Treatment options include per oral endoscopic myotomy (POEM), laparoscopic Heller myotomy (LM) and endoscopic treatments such as pneumatic dilation (PD) and botulinum toxin type A injections (BI). We evaluate the economics and cost-effectiveness of treating achalasia. METHODS: We performed cost analysis for POEM, LM, PD and BI at our institution from 2011 to 2015...
August 17, 2016: Surgical Endoscopy
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