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laparoscopic heller myotomy

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https://www.readbyqxmd.com/read/29019558/late-evaluation-of-dysphagia-after-heller-esophageal-myotomy-with-dor-fundoplication-for-achalasia
#1
Eduardo Rodrigues Zarco Câmara, Fernando Athayde Veloso Madureira, Delta Madureira, Renato Manganelli Salomão, Antonio Carlos Ribeiro Garrido Iglesias
BACKGROUND: All available treatments for achalasia are palliative and aimed to eliminate the flow resistance caused by a hypertensive lower esophageal sphincter. AIM: To analyze the positive and negative prognostic factors in the improvement of dysphagia and to evaluate quality of life in patients undergoing surgery to treat esophageal achalasia by comparing findings before, immediately after, and in long follow-up. METHODS: A total of 84 patients who underwent surgery for achalasia between 2001 and 2014 were retrospectively studied...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28989059/clinical-practice-update-the-use-of-per-oral-endoscopic-myotomy-in-achalasia-expert-review-and-best-practice-advice%C3%A2-from-the-american-gastroenterological-association
#2
REVIEW
Peter J Kahrilas, David Katzka, Joel E Richter
The purpose of this review is to describe a place for per-oral endoscopic myotomy (POEM) among the currently available robust treatments for achalasia. The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations: 1) in determining the need for achalasia therapy, patient-specific parameters (Chicago Classification subtype, comorbidities, early vs late disease, primary or secondary causes) should be considered along with published efficacy data; 2) given the complexity of this procedure, POEM should be performed by experienced physicians in high-volume centers because an estimated 20-40 procedures are needed to achieve competence; 3) if the expertise is available, POEM should be considered as primary therapy for type III achalasia; 4) if the expertise is available, POEM should be considered as treatment option comparable with laparoscopic Heller myotomy for any of the achalasia syndromes; and 5) post-POEM patients should be considered high risk to develop reflux esophagitis and advised of the management considerations (potential indefinite proton pump inhibitor therapy and/or surveillance endoscopy) of this before undergoing the procedure...
October 6, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28966450/comparison-of-outcomes-of-laparoscopic-heller-myotomy-versus-per-oral-endoscopic-myotomy-for-management-of-achalasia
#3
Steven G Leeds, J S Burdick, Gerald O Ogola, Estrellita Ontiveros
Achalasia is a rare disorder that has several treatment options. The gold standard of treatment is a surgical myotomy called a laparoscopic Heller myotomy (LHM). More recently, an endoscopic myotomy has become an option as well, called per-oral endoscopic myotomy (POEM). An achalasia registry was queried for patients undergoing either LHM or POEM at Baylor University Medical Center at Dallas. Patient demographics, preoperative and postoperative data points, and Eckardt scores were collected. The patients were further stratified into their follow-up intervals, immediate postoperative and long-term follow-up, to assess surgical success...
October 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28958274/age-and-achalasia-how-does-age-affect-patient-presentation-hospital-course-and-surgical-outcomes
#4
Darrell J Downs, Giavanna Jadick, Forat Swaid, Sharona B Ross, Alexander S Rosemurgy
Heller myotomy is the "gold-standard" therapy for achalasia, alleviating symptoms by defunctionalizing the lower esophageal sphincter mechanism. Observation has suggested many differences between young and old patients with achalasia, raising the question: is achalasia in younger patients a different disorder than it is in older patients? This study was undertaken to answer this question. With Institutional Review Board approval, 648 patients undergoing laparoscopic Heller myotomy from 1992-2016 were prospectively followed up...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28953511/therapeutic-outcome-of-achalasia-based-on-high-resolution-manometry-a-korean-multicenter-study
#5
Hyuk Lee, Hyunsoo Chung, Tae Hee Lee, Kyoung Sup Hong, Young Hoon Youn, Jung Ho Park, Hyung Seok Park, Hyojin Park
BACKGROUND: Because achalasia subtype is associated with therapeutic response, it is possible that regional differences in subtype distribution could lead to differences in therapeutic outcomes. STUDY QUESTION: We aimed to evaluate and compare high-resolution manometry (HRM) profiles among the different subtypes of achalasia and to elucidate predictive factors associated with treatment outcomes. STUDY DESIGN: Patients who were diagnosed with achalasia using HRM at 4 Korean university hospitals were retrospectively identified and analyzed...
September 11, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28935197/laparoscopic-heller-myotomy-after-previous-roux-en-y-gastric-bypass
#6
T Javier Birriel, Leonardo Claros, Maher El Chaar
No abstract text is available yet for this article.
August 25, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28924729/dor-vs-toupet-fundoplication-after-laparoscopic-heller-myotomy-long-term-randomized-controlled-trial-evaluated-by-high-resolution-manometry
#7
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
#8
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/28839899/poem-and-the-management-of-achalasia
#9
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/28836246/-clinical-experience-of-combined-laparoscopic-endoscopic-heller-myotomy-and-modified-dor-fundoplication-for-cardiochalasia
#10
Xiaofang Qiao, Jinlong Li, Hua Xu, Xin Wan, Jiaming Zhu
OBJECTIVE: To investigate the efficacy of combined laparoscopic-endoscopic lower esophageal sphincterotomy and modified Dor fundoplication for cardiochalasia patients. METHODS: Clinical data of 11 cardiochalasia patients who underwent combined laparoscopic-endoscopic lower esophageal sphincterotomy and modified Dor fundoplication by the same medical team from January 2015 to December 2016 at The Second Hospital of Jilin University were retrospectively analyzed. The procedure was as follows: an incision was made in the anterior wall of esophagus and dissection of esophageal muscular layer was performed, then the bulged esophageal mucosa was covered by the fundus after 180 degrees fold to the right (fundoplication), finally the gastric fundus was joined to the right diaphragmatic foot by 3 to 5 knotted suture...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28740664/development-of-a-novel-ex-vivo-porcine-laparoscopic-heller-myotomy-and-nissen-fundoplication-training-model-toronto-lap-nissen-simulator
#11
Hideki Ujiie, Tatsuya Kato, Hsin-Pei Hu, Patrycja Bauer, Priya Patel, Hironobu Wada, Daiyoon Lee, Kosuke Fujino, Colin Schieman, Andrew Pierre, Thomas K Waddell, Shaf Keshavjee, Gail E Darling, Kazuhiro Yasufuku
BACKGROUND: Surgical trainees are required to develop competency in a variety of laparoscopic operations. Developing laparoscopic technical skills can be difficult as there has been a decrease in the number of procedures performed. This study aims to develop an inexpensive and anatomically relevant model for training in laparoscopic foregut procedures. METHODS: An ex vivo, anatomic model of the human upper abdomen was developed using intact porcine esophagus, stomach, diaphragm and spleen...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28724307/per-oral-endoscopic-myotomy-poem-a-new-endoscopic-treatment-for-achalasia
#12
Pablo Miranda García, Fernando Casals Seoane, Jean-Michel Gonzalez, Marc Barthet, Cecilio Santander Vaquero
BACKGROUND/AIMS: Per-oral endoscopic myotomy (POEM) is a new minimally invasive technique to treat achalasia. METHODS: We performed a review of the literature of POEM with a special focus on technical details and the results obtained with this technique in patients with achalasia and other esophageal motility disorders. RESULTS: Thousands of POEM procedures have been performed worldwide since its introduction in 2008. The procedure is based on the creation of a mucosal entry point in the proximal esophagus to reach the cardia through a submucosal tunnel and then perform a myotomy of the muscular layers of the cardia, esophagogastric junction and distal esophagus, as performed in a Heller myotomy...
October 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28711287/in-vivo-experience-with-poem-an-essential-activity-for-developing-the-technique-in-humans
#13
A Peñaloza-Ramírez, J Suárez-Correa, J Báez-Blanco, C Sabogal-Gómez, H Kuan-Casas, C Sánchez-Pignalosa, P Aponte-Ordóñez
INTRODUCTION AND OBJECTIVES: Achalasia is the most widely studied esophageal motility disorder. No treatment has achieved completely satisfactory results. The laparoscopic Heller esophagomyotomy is currently the most accepted technique. With the advent of minimally invasive surgery, the appearance of peroral endoscopic submucosal myotomy (POEM) has promising results. The primary aim of our study was to perform peroral endoscopic esophagomyotomy in animal experimentation models to perfect the technique and later apply it to humans...
July 12, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28702097/pediatric-achalasia-single-center-study-of-interventional-treatment
#14
Andrzej Grabowski, Wojciech Korlacki, Michał Pasierbek, Roksana Pułtorak, Filip Achtelik, Maciej Ilewicz
INTRODUCTION: Esophageal achalasia is a rare entity in children. However, young age is a factor of failure of conservative treatment, emphasizing the role of surgery. In our institution laparoscopic Heller's cardiomyotomy is the chosen procedure for surgical treatment. AIM: To assess the outcome of surgery for achalasia treatment in children operated on in a single institution. MATERIAL AND METHODS: A retrospective analysis of consecutive patient records from the years 1997 to 2014 was performed...
2017: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/28686640/learning-curve-for-laparoscopic-heller-myotomy-and-dor-fundoplication-for-achalasia
#15
Fumiaki Yano, Nobuo Omura, Kazuto Tsuboi, Masato Hoshino, Seryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga
PURPOSE: Although laparoscopic Heller myotomy and Dor fundoplication (LHD) is widely performed to address achalasia, little is known about the learning curve for this technique. We assessed the learning curve for performing LHD. METHODS: Of the 514 cases with LHD performed between August 1994 and March 2016, the surgical outcomes of 463 cases were evaluated after excluding 50 cases with reduced port surgery and one case with the simultaneous performance of laparoscopic distal partial gastrectomy...
2017: PloS One
https://www.readbyqxmd.com/read/28664434/clinical-outcomes-five-years-after-poem-for-treatment-of-primary-esophageal-motility-disorders
#16
Ezra N Teitelbaum, Christy M Dunst, Kevin M Reavis, Ahmed M Sharata, Marc A Ward, Steven R DeMeester, Lee L Swanström
BACKGROUND: Peroral endoscopic myotomy (POEM) is a novel operation for the treatment of achalasia and other esophageal motility disorders. While POEM has shown excellent short-term safety and efficacy, the long-term symptomatic outcomes after the procedure are unknown. METHODS: Patients from a single center that underwent POEM for treatment of esophageal motility orders and were greater than 5 years removed from their operation were studied. Patients were contacted to assess current symptoms and encouraged to undergo repeat endoscopy for objective follow-up...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28660419/per-oral-endoscopic-myotomy-vs-laparoscopic-heller-myotomy-does-gastric-extension-length-matter
#17
Mauricio Ramirez, Cecilia Zubieta, Franco Ciotola, Alfredo Amenabar, Adolfo Badaloni, Fabio Nachman, Alejandro Nieponice
OBJECTIVE: To report our experience in POEM vs. LHM, with particular focus on myotomy extension. BACKGROUND: POEM has been adopted worldwide as a treatment for achalasia. While resolution of dysphagia is above 90%, postoperative reflux ranges from 10 to 57%. Myotomy length has been a controversial topic. METHODS: Thirty-five cases of POEM were prospectively analyzed and compared retrospectively to the last 35 patients that underwent LHM, from December 2010 to August 2016...
June 28, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28617881/is-heller-myotomy-better-than-balloon-dilation-a-meta-analysis
#18
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
#19
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...
August 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28570426/acute-mucosal-perforation-after-laparoscopic-heller-myotomy-in-a-child
#20
Juan Tang, Wei-Tao Liang, Song-Song Ma, Feng Wang, Ji-Min Wu
No abstract text is available yet for this article.
May 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
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