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Alexandru Eugen Nicolau, Adrian Lobonţiu, Silviu Constantinoiu
GERD has become one of the most frequent pathology of the upper GI tract. It is a spectrum disease and is a progressive disease as well. Serious and severe complications are possible. The mainstream therapy in most of the patients is the medical therapy with PPI's. The most severe cases with an impaired LES (Lower Esophageal Sphincter) function as well as important anatomical disruptions are of surgical indication, the gold standard being laparoscopic fundoplication, an elective therapy with long term follow up outcomes at the expense of de novo symptoms associated with fundoplications in general...
January 2018: Chirurgia
William Kethman, Mary Hawn
BACKGROUND: Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disorder of the esophagus. It is a chronic, progressive disorder that presents most typically with heartburn and regurgitation and atypically with chest pain, dysphagia, chronic cough, globus, or sore throat. The mainstay for diagnosis and characterization of the disorder is esophagoduodenoscopy (EGD), high-resolution esophageal manometry, and symptom-associated ambulatory esophageal pH impedance monitoring...
September 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
K U Asche, A Kaindlstorfer, R Pointner
An optimal functioning of the gastroesophageal antireflux barrier depends on an anatomical overlapping of the lower esophageal sphincter and the crural diaphragm. Restoration of this situation is currently only possible by antireflux interventions combined with hiatoplasty and necessitates a laparoscopic approach. Newer alternative techniques to the generally accepted fundoplication are laparoscopic implantation of the LINX® device or the EndoStim® system and various endoscopic antireflux procedures, such as radiofrequency energy treatment, plication and implantation techniques aimed at augmentation of the gastroesophageal valve...
March 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Edy Soffer, Leonardo Rodríguez, Patricia Rodriguez, Beatriz Gómez, Manoel G Neto, Michael D Crowell
AIM: To evaluate the efficacy of lower esophageal sphincter (LES)-electrical stimulation therapy (EST) in a subgroup of patients that reported only partial response to proton pump inhibitors (PPIs) therapy, compared to a group of patient with complete response. METHODS: Bipolar stitch electrodes were laparoscopically placed in the LES and connected to an implantable pulse generator (EndoStim BV, the Hague, the Netherlands), placed subcutaneously in the anterior abdominal wall...
February 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
Michael S Gossman
OBJECTIVE: This testing was conducted to determine if exposure from a particle accelerator used to treat cancer patients would alter the performance of the EndoStim® neurostimulator when programmed either passively or actively and while being irradiated. METHODS: A total of 12 EndoStim Lower Esophageal Sphincter (LES) Stimulation System implantable neurostimulators were investigated in this research. Included were six each of the EndoStim I and EndoStim II. Half were used for passive testing, with the remaining half for active testing...
December 2015: Neuromodulation: Journal of the International Neuromodulation Society
Leonardo Rodríguez, Patricia Rodriguez, Beatriz Gómez, Juan C Ayala, Danny Oxenberg, Alberto Perez-Castilla, Manoel G Netto, Edy Soffer, W John Boscardin, Michael D Crowell
BACKGROUND: Lower esophageal sphincter (LES) electrical stimulation therapy (EST) has been shown to improve outcome in gastroesophageal reflux disease (GERD) patients at 1 year. The aim of this open-label extension trial (NCT01578642) was to study the 2-year safety and efficacy of LES-EST in GERD patients. METHODS: GERD patients responsive partially to proton pump inhibitors (PPI) with off-PPI GERD health-related quality of life (HRQL) of ≥20, 24-hour esophageal pH ≤4...
March 2015: Surgery
Toshitaka Hoppo, Leonardo Rodríguez, Edy Soffer, Michael D Crowell, Blair A Jobe
INTRODUCTION: Electrical stimulation of the lower esophageal sphincter (LES) in gastroesophageal reflux disease (GERD) patients, using EndoStim(®) LES stimulation system (EndoStim BV, the Hague, Netherlands), enhances LES pressure, decrease distal esophageal acid exposure, improves symptoms, and eliminates the need in many patients for daily GERD medications. AIM: To evaluate, in a post hoc analysis, the effect of LES stimulation on proximal esophageal acid exposure in a subgroup of patients with abnormal proximal esophageal acid exposure...
December 2014: Surgical Endoscopy
Franco Ciotola, Andres Ditaranto, Claudio Bilder, Adolfo Badaloni, Daniel Lowenstein, Juan Martin Riganti, Toshitaka Hoppo, Blair Jobe, Fabio Nachman, Alejandro Nieponice
INTRODUCTION: Postoperative reflux remains to be a challenge for patients with achalasia undergoing Heller myotomy. Similarly, per-oral endoscopic myotomy (POEM) is gaining rapid acceptance but the impossibility of adding a fundoplication is questioned as the main pitfall to control reflux. Electrical stimulation of the lower esophageal sphincter (LES) has emerged as a new alternative for the treatment of reflux disease. The objective of this study was to evaluate the potential benefits of combining electrical stimulation with endoscopic esophageal myotomy to prevent post procedural reflux...
January 2015: Surgical Endoscopy
L Rodríguez, P Rodriguez, B Gómez, J C Ayala, D Oksenberg, A Perez-Castilla, M G Netto, E Soffer, M D Crowell
BACKGROUND AND STUDY AIMS: In patients with gastroesophageal reflux disease (GERD), temporary electrical stimulation of the lower esophageal sphincter (LES) increases LES pressure without interference with LES relaxation. The aim of the current study was to investigate the safety and efficacy of long term LES electrical stimulation therapy (LES-EST), using a permanently implanted stimulator for the treatment of GERD. PATIENTS AND METHODS: Patients with GERD who were at least partially responsive to proton pump inhibitors (PPIs) and who had hiatal hernia of ≤ 3 cm and esophagitis of Los Angeles Grade A, B, or C were included in the study...
August 2013: Endoscopy
Sumanth R Daram, Shou-Jiang Tang, Thomas L Abell
BACKGROUND: Studies have shown high-frequency, low-energy gastric electrical stimulation (GES) to be an effective management strategy for patients with medication refractory gastroparesis. However, placement of a permanent GES device requires surgery and has considerable cost considerations. More importantly, however, this mode of therapy may not be successful for all patients. Patients likely to benefit from such an invasive and expensive procedure could be selected on the basis of their response to temporary GES...
October 2011: Surgical Endoscopy
Srinivasa Ayinala, Oscar Batista, Amit Goyal, Amar Al-Juburi, Nighat Abidi, Babajide Familoni, Thomas Abell
BACKGROUND: Gastric electrical stimulation (GES) has been shown to be efficacious for drug refractory gastroparesis, but GES requires surgery. Placement of temporary GES electrodes endoscopically (ENDOstim) or via a PEG (PEGstim) is feasible, thereby allowing rapid assessment and comparison of temporary use (TEMP) with permanent (PERM) implantation. METHODS: Twenty consecutive patients with gastroparesis had TEMP electrodes placed (6 ENDOstim, 14 PEGstim). TEMP alone and TEMP vs...
March 2005: Gastrointestinal Endoscopy
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