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Esophageal dilation endoscopic

Yusuke Tonai, Ryu Ishihara, Yasushi Yamasaki, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Yasuhiko Tomita, Hiroyasu Iishi
Background and study aims: Better endoscopic diagnosis in case of Barrett's esophagus is still needed. White globe appearance (WGA) is a novel endoscopic marker for gastric adenocarcinoma, with high sensitivity for differentiating between gastric cancer/high-grade dysplasia and other lesions. We report 2 cases of esophageal adenocarcinoma with WGA. In Case 1, esophagogastroduodenoscopy (EGD) revealed a 10-mm esophageal adenocarcinoma in a 48-year-old Japanese woman with short-segment Barrett's esophagus. A small (< 1 mm) white globular lesion, typical of WGA, was observed under the epithelium by magnifying narrow-band imaging...
October 2016: Endoscopy International Open
Frank Zerbib
Eosinophilic esophagitis is a major cause of dysphagia and esophageal food impaction in young adults, although the diagnostic can be made in older patients. The diagnosis of eosinophilic esophagitis is suspected on endoscopic abnormalities of esophageal mucosa and confirmed by esophageal biopsy samples. Approximately 50% of patients with eosinophilic esophagitis do respond to proton pump inhibitors therapy. The first line therapy for eosinophilic esophagitis is proton pump inhibitor therapy. Ingested topical steroids represent a second-line therapy...
October 10, 2016: La Presse Médicale
Luiz Gustavo de Quadros, Roberto Luiz Kaiser, Manoel Dos Passos Galvão, Josemberg Marins Campos, Marcelo Falcão de Santana, Alvaro Antonio Bandeira Ferraz
Background: A multitude of endoscopic findings post-gastric bypass procedures have been previously reported in the literature, but to our knowledge, no present rules exist that could guide clinicians regarding which findings should be actively sought, once an initial finding is identified. Objective: To identify co-occurrence patterns among endoscopic findings of patients having undergone past gastric bypass procedure. Methods: Our registry involves all consecutive patients undergoing an upper endoscopic evaluation after a gastric bypass procedure...
October 2016: Arquivos de Gastroenterologia
Nisha A Shah, Dustin M Albert, Noah M Hall, Fouad J Moawad
Eosinophilic esophagitis (EoE) is a chronic and progressive immune-mediated condition defined by symptoms of esophageal dysfunction and dense eosinophilic infiltration of the esophageal mucosa. Therapies consist of anti-eosinophilic medications and specialized diets aimed to decrease the progression of EoE and alleviate its symptoms, namely, dysphagia and food impaction. Assessing response to therapy remains challenging, as treatment end points are not well defined and currently consist of clinical, histologic, and endoscopic features...
2016: Clinical and Experimental Gastroenterology
Han-Yu Deng, Wen-Ping Wang, Yi-Dan Lin, Long-Qi Chen
A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was 'Can mitomycin facilitate endoscopic dilatation treatment of benign esophageal stricture (mainly including caustic and anastomotic esophageal stricture)?' Altogether, 115 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question, which included 1 randomized controlled trial, 1 systematic review and 4 cohort studies. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
September 23, 2016: Interactive Cardiovascular and Thoracic Surgery
Saowanee Ngamruengphong, Haruhiro Inoue, Philip Chiu, Hon-Chi Yip, Amol Bapaye, Michael Ujiki, Lava Patel, Pankaj N Desai, Bu Hayee, Amyn Haji, Vivien 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: Per-oral endoscopic myotomy (POEM) has shown promising safety and efficacy in short-term studies. However, long term follow-up data is 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
A Swager, G J Tearney, C L Leggett, M G H van Oijen, S L Meijer, B L Weusten, W L Curvers, J J Bergman
BACKGROUND AND AIMS: volumetric laser endomicroscopy (VLE) provides a circumferential scan that enables the visualization of subsurface layers of the esophageal wall at 7 μm resolution. The aims of this study were to identify VLE features ofBarrett's esophagus (BE) neoplasia and to develop a VLE prediction score. METHODS: A database of VLE images from endoscopic resection specimens, precisely correlated with histology, from BE patients +/- neoplasia was used. Features potentially predictive for early BE neoplasia were identified by unblinded evaluation of 25 VLE-histology images...
September 19, 2016: Gastrointestinal Endoscopy
Yasuaki Nagami, Masatsugu Shiba, Kazunari Tominaga, Masaki Ominami, Shusei Fukunaga, Satoshi Sugimori, Fumio Tanaka, Noriko Kamata, Tetsuya Tanigawa, Hirokazu Yamagami, Toshio Watanabe, Yasuhiro Fujiwara, Tetsuo Arakawa
BACKGROUND AND STUDY AIM: The incidence of stricture formation caused by endoscopic submucosal dissection (ESD) for widespread lesions is high, and stricture formation can reduce quality of life. We evaluated the prophylactic efficacy of hybrid therapy using a locoregional steroid injection and polyglycolic acid (PGA) sheets with fibrin glue to prevent stricture formation after esophageal ESD in high risk patients in whom we predicted stricture formation would be difficult to prevent with a single prophylactic steroid injection...
September 2016: Endoscopy International Open
Federico Marchesi, Chiara Rapacchi, Vittoria Pattonieri, Francesco Tartamella, Maria Teresa Mita, Stefano Cecchini
Refractory esophageal strictures are a common sequela of caustic ingestion. If endoscopic dilation becomes ineffective, esophagectomy represents the only therapeutic option. The minimally invasive approach, specifically the thoracoscopic access in prone position, may allow postoperative morbidity to be reduced. We present the first case described in the Literature of minimally invasive esophagectomy in prone position for a long-term failure of endoscopic dilation after caustic ingestion.
2016: Acta Bio-medica: Atenei Parmensis
Selcuk Disibeyaz, Erkin Oztas, Ufuk B Kuzu, Mustafa Ozdemir
Most ingested foreign bodies are best treated with endoscopically. If the sharp-pointed objects embedded in the esophageal wall, it may not be able to be removed by conventional endoscopic devices and surgery is required. Herein, we described a new technique for the extraction of both ends embedded sharp-pointed objects in the esophageal wall.
October 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Stavros N Stavropoulos, David Friedel, Rani Modayil, Henry P Parkman
Achalasia is a rare esophageal motility disorder that is usually idiopathic in origin. It is characterized by dysphagia, and patients often have chest pain, regurgitation, weight loss, and an abnormal barium radiograph showing esophageal dilation with narrowing at the gastroesophageal junction. Abnormal or absent esophageal peristalsis and impaired relaxation of the lower esophageal sphincter (LES) are typically seen on esophageal manometry. The advent of high resolution manometry (HRM) has allowed more precise diagnosis of achalasia, subtype designation, and differentiation from other esophageal motor disorders with an initial seminal publication in 2008 followed by further refinements of what has been termed the Chicago classification...
2016: BMJ: British Medical Journal
Mihir S Wagh, Peter V Draganov
BACKGROUND AND AIM: Total aphagia from complete esophageal obstruction (CEO) can be seen in patients with head-neck or thoracic malignancies undergoing chemoradiation or surgery. Combined antegrade and retrograde endoscopy (via G-tube tract) is often performed for esophageal reconstruction but is limited by the length of the obstructed esophagus. We describe per-oral endoscopic tunneling for restoration of the esophagus (POETRE), for patients with longer segments of esophageal obstruction...
September 6, 2016: Gastrointestinal Endoscopy
Hajime Takayasu, Kouji Masumoto, Miki Ishikawa, Takato Sasaki, Kentaro Ono
Recurrent tracheoesophageal fistula (TEF) is still difficult to diagnose and repair. In almost all cases, recurrence appears relatively soon after the primary surgery. We herein describe a case of recurrent TEF that appeared 10 years after the primary repair. At 2 years of age, the patient suffered from mental retardation due to encephalitis and developed a hiatus hernia with gastro-esophageal reflux. He underwent the repair of a hiatus hernia and fundoplication at 3 years of age. However, the hiatus hernia recurred 6 months after the operation...
December 2016: Surgical Case Reports
Emo E van Halsema, Irma C Noordzij, Mark I van Berge Henegouwen, Paul Fockens, Jacques J Bergman, Jeanin E van Hooft
BACKGROUND: The optimal target of endoscopic dilation of postsurgical esophageal strictures is unknown. Our aim was to compare the dilation-free period of patients who underwent dilation up to 16 mm with patients who were dilated up to 17 or 18 mm. METHODS: We retrospectively analyzed adult patients who received bougie/balloon dilation for a benign anastomotic stricture after esophagectomy. An anastomotic stricture was defined as dysphagia in combination with a luminal diameter of ≤13 mm at endoscopy...
September 1, 2016: Surgical Endoscopy
Parakrama Chandrasoma, Tom DeMeester
Diagnosis of gastroesophageal reflux disease (GORD) is delayed by the lack of uniform histopathologic criteria for diagnosis. The only practical value of pathology is the assessment of columnar lined esophagus (CLO). As a result, GORD is treated with acid suppressive drug therapy until there is a failure to control symptoms and/or advanced adenocarcinoma develops. The reasons why there is a failure of pathologic diagnosis are two false dogmas that result in two widely believed fundamental errors. These are the belief that cardiac epithelium normally lines the proximal stomach (1) and that the gastroesophageal junction (GOJ) is defined by the proximal limit of rugal folds (2)...
2016: Advances in Experimental Medicine and Biology
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
Roxana M Coman, Takuji Gotoda, Christopher E Forsmark, Peter V Draganov
BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) carries significant advantages over endoscopic mucosal resection. As such, ESD is an established therapy for esophageal squamous cell carcinoma but there are only limited data on ESD as therapy for Barrett's esophagus (BE). Thus, we prospectively evaluated the outcomes of ESD in patients with BE with high-grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC) performed in a Western center. PATIENTS AND METHODS: This is a prospective cohort study...
June 2016: Endoscopy International Open
Brian E Louie, Andreas M Schneider, Drew B Schembre, Ralph W Aye
BACKGROUND: Per oral endoscopic myotomy (POEM) is performed by accessing the submucosal space of the esophagus. This space may be impacted by prior interventions such as submucosal injections, dilations or previous myotomies. These interventions could make POEM more difficult and may deter surgeons during their initial experience. We sought to determine the impact of prior interventions on our early experience. METHODS: Prospective, single-center study of consecutive patients undergoing POEM...
August 23, 2016: Surgical Endoscopy
Woong Ki Lee, Byung Sun Kim, Min A Yang, So Hee Yun, Young Jae Lee, Ji Woong Kim, Jin Woong Cho
Bougie or balloon dilation is a good short-term treatment for caustic esophageal strictures, although recurrence after dilation occurs in approximately 30% of these cases. Therefore, long-term treatment options are required in some cases, and endoscopic incisional therapy has been used for patients with an anastomotic stricture in the gastrointestinal tract. A 58-year-old woman presented with severe swallowing difficulty because of a caustic esophageal stricture, which was caused by accidental exposure to anhydrous acetic acid at infancy...
August 12, 2016: Clinical Endoscopy
Shrihari Anil Anikhindi, Piyush Ranjan, Munish Sachdeva, Mandhir Kumar
BACKGROUND: Self-expanding plastic stents (SEPS) have emerged as a good alternative to surgery in esophageal leaks and fistulae. There is scarce published literature regarding its efficacy in these conditions. We present our experience with SEPS in treatment of esophageal leaks and fistulae. METHODS: Consecutive patients admitted in a tertiary referral center who underwent SEPS placement for esophageal leak or fistula between February 2012 and February 2015 were retrospectively evaluated...
July 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
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