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Esophageal dilation endoscopic

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https://www.readbyqxmd.com/read/29022068/esophagectomy-for-end-stage-achalasia-systematic-review-and-meta-analysis
#1
REVIEW
Alberto Aiolfi, Emanuele Asti, Gianluca Bonitta, Luigi Bonavina
BACKGROUND: Indications for surgery and clinical outcomes of esophagectomy in the management of end-stage achalasia are not clearly defined. The aim of this systematic review and meta-analysis was to provide evidence-based information to help in the decision-making and in the choice of surgical technique. METHODS: An extensive literature search was conducted to identify all reports on esophagectomy for end-stage achalasia patients over the past three decades. MEDLINE, Embase and Cochrane databases were thoroughly consulted matching the terms "achalasia," "end-stage achalasia," "esophagectomy" and "esophageal resection" with "AND" and "OR...
October 11, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29018965/the-role-of-maintenance-therapy-in-eosinophilic-esophagitis-who-why-and-how
#2
REVIEW
Hamish Philpott, Evan S Dellon
In patients with eosinophilic esophagitis (EoE) who do not respond to proton pump inhibitors, initial anti-inflammatory/anti-eosinophilic treatment is with either topical corticosteroids or dietary elimination. A large body of literature supports the efficacy of these approaches, with histologic response rates in the 50-90% range for steroids and 70% range for the six-food elimination diet. However, these studies are almost all short-term and data evaluating long-term safety and efficacy of either treatment are limited...
October 10, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28987502/optimal-histologic-cutpoints-for-treatment-response-in-patients-with-eosinophilic-esophagitis-analysis-of-data-from-a-prospective-cohort-study
#3
Craig C Reed, W Asher Wolf, Cary C Cotton, Spencer Rusin, Irina Perjar, Johnathan Hollyfield, John T Woosley, Nicholas J Shaheen, Evan S Dellon
BACKGROUND AND AIMS: No prospective studies substantiate 15 eos/hpf as an appropriate endpoint for treatment of eosinophilic esophagitis (EoE). We aimed to determine a histologic cutpoint that identifies successful treatment of EoE by assessing symptomatic and endoscopic improvement. METHODS: We performed a prospective cohort study of 62 consecutive adult patients undergoing outpatient esophagogastroduodenoscopy at the University of North Carolina from 2009 through 2014...
October 4, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28981080/improvement-in-esophageal-distensibility-in-response-to-medical-and-diet-therapy-in-eosinophilic-esophagitis
#4
Dustin A Carlson, Ikuo Hirano, Angelika Zalewski, Nirmala Gonsalves, Zhiyue Lin, John E Pandolfino
OBJECTIVES: We aimed to evaluate the effect of medical and diet therapies on esophageal distensibility assessed using the functional lumen imaging probe (FLIP) and the association of changes in esophageal distensibility with clinical outcomes in eosinophilic esophagitis (EoE). METHODS: Patients with EoE were evaluated with FLIP during endoscopy at baseline and following therapy without interval dilatation. Evaluation also included a validated patient-reported outcome (PRO; a positive PRO was considered at a 30% score improvement), mucosal biopsies, and scoring of endoscopic features of EoE...
October 5, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28956250/hypopharyngeal-applications-of-a-new-flexible-robotic-system-in-otolaryngology
#5
Janet Ren Chao, Joseph Goodman, Andrew Fuson, Nahir J Romero, Arjun Joshi
This case report describes the use a new flexible robotic system in otolaryngology, the FlexRobot(®) for cricopharyngeal myotomy in cadaver dissections, and for the treatment of a patient with esophageal stenosis and secondary dysphagia and dysphonia. The Flexrobot(®) facilitates access to the hypopharynx with increased proximity to the surgical field and improved optics, allowing more exact dilatation and injection in our patient. It also would allow surgeons to reach deep inside the cavity of the hypopharynx into anatomical regions that are typically inaccessible without an open approach, as shown in our cadaveric procedure, where full exposure of the posterior aspect of the cricopharyngeus and isolation of the muscle belly were achieved...
September 27, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28942656/use-of-self-expanding-nitinol-stents-in-the-pediatric-management-of-refractory-esophageal-caustic-stenosis
#6
Verónica Alonso, Devicka Ojha, Harsha Nalluri, Juan Carlos de Agustín
BACKGROUND: The treatment of recurrent esophageal stricture secondary to the ingestion of a caustic agent is an arduous task. Self-expanding esophageal stents may be an alternative to repeated endoscopic esophageal dilations. CASE REPORT: We present the case of a two-year-old male with a severe and long esophageal stricture successfully treated by the combination of dilations and stent placement. After five months of serial pneumatic dilations, three self-expanding nitinol stents internally coated with silicone were introduced through a gastrostomy, covering the entire esophagus...
October 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28895370/eosinophilic-esophagitis-current-evidence-based-diagnosis-and-treatment-in-children-and-adults
#7
Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a disease caused by an immune response to food antigens in contact with the esophageal mucosa that has arisen as a common disorder in current clinical practice. Its diagnosis is defined by the combination of symptoms of esophageal dysfunction and inflammation of the esophageal mucosa predominantly by eosinophils. Its chronic course and frequent progression to subepithelial fibrosis leading to strictures and narrow-caliber esophagus indicate the need for treatment. Information provided by recent clinical trials and systematic reviews allowed for the development of new clinical guidelines, endorsed by several European scientific societies...
September 11, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28885305/successful-esophageal-dilation-of-eosinophilic-esophagitis-eoe-patients-with-a-previous-postdilation-complication-start-low-and-go-slow
#8
Seth Lipka, Ambuj Kumar, Joel E Richter
INTRODUCTION: Esophageal dilation is an effective and safe treatment option for fibrostenotic eosinophilic esophagitis (EoE). Despite the safety, adverse events occur, yet there is scarce literature on the best treatment postcomplications. METHODS: Patients with diagnosis of EoE (≥15 eosinophils per high-power field) from 2011 to 2015 treated at our center were included. Thirty patients with fibrostenotic disease had records available regarding serial dilation therapy...
September 6, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28881900/changes-in-esophageal-motility-after-endoscopic-submucosal-dissection-for-superficial-esophageal-cancer-a-high-resolution-manometry-study
#9
K Takahashi, Y Sato, M Takeuchi, H Sato, N Nakajima, S Ikarashi, K Hayashi, K-I Mizuno, Y Honda, S Hashimoto, J Yokoyama, S Terai
The effect of endoscopic submucosal dissection (ESD) on esophageal motility remains unknown. Therefore, the aim of this study is to elucidate changes in esophageal motility after ESD along with the cause of dysphagia using high-resolution manometry (HRM). This is a before-and-after trial of the effect of ESD on the esophageal motility. Twenty patients who underwent ESD for superficial esophageal carcinoma were enrolled in this study. Patients filled out a questionnaire about dysphagia and underwent HRM before and after ESD...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28881899/polyglycolic-acid-sheet-and-fibrin-glue-for-preventing-esophageal-stricture-after-endoscopic-submucosal-dissection-a-historical-control-study
#10
T Iizuka, D Kikuchi, S Hoteya, Y Kajiyama, M Kaise
There have been several reports that steroid administration is effective at preventing strictures after endoscopic submucosal dissection (ESD). However, adverse events after steroid use are of great concern. We have reported that shielding with a polyglycolic acid (PGA) sheet and fibrin glue can be useful for prevention of stricture after ESD. We conducted a retrospective analysis of efficiency of shielding with a PGA sheet and fibrin glue for prevention of esophageal stricture compared with intralesional steroid injection...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28867969/an-overview-of-achalasia-and-its-subtypes
#11
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/28843584/esophageal-triamcinolone-acetonide-filling-method-a-novel-procedure-to-prevent-stenosis-after-extensive-esophageal-endoscopic-submucosal-dissection-with-videos
#12
Kotaro Shibagaki, Norihisa Ishimura, Naoki Oshima, Tsuyoshi Mishiro, Nobuhiko Fukuba, Yuji Tamagawa, Noritsugu Yamashita, Hironobu Mikami, Daisuke Izumi, Hideaki Taniguchi, Shuichi Sato, Shunji Ishihara, Yoshikazu Kinoshita
BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) for extensive esophageal carcinomas may cause severe stenosis requiring endoscopic balloon dilations (EBDs). A standard prevention method has not been established. We propose the esophageal triamcinolone acetonide (TA)-filling method as a novel local steroid administration procedure. METHODS: We enrolled 22 consecutive patients with early esophageal cancer who were treated using either subcircumferential or circumferential ESD (15 and 7 procedures, respectively) in this case series...
August 24, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28840483/endoscopic-management-of-benign-esophageal-strictures
#13
REVIEW
William J Ravich
PURPOSE OF REVIEW: This paper presents the author's approach to esophageal dilation. It offers a tailored approach to the application of dilation to specific types of esophageal stenotic lesions. RECENT FINDINGS: In patients with inflammatory stricture, recent studies confirm the importance of treating the underlying inflammatory condition in order to decrease the rate of recurrence. The paper reviews some of the novel techniques that have been suggested for the treatment of refractory benign esophageal strictures, including incisional therapy, stenting, or the injection steroids or antifibrotic agents...
August 24, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28836246/-clinical-experience-of-combined-laparoscopic-endoscopic-heller-myotomy-and-modified-dor-fundoplication-for-cardiochalasia
#14
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/28835774/endoscopic-management-of-complications-of-self-expandable-metal-stents-for-treatment-of-malignant-esophageal-stenosis-and-tracheoesophageal-fistulas
#15
Renáta Bor, Anna Fábián, Anita Bálint, Klaudia Farkas, Mónika Szűcs, Ágnes Milassin, László Czakó, Mariann Rutka, Tamás Molnár, Zoltán Szepes
BACKGROUND: Self-expandable metal stent (SEMS) implantation may rapidly improve the symptoms of malignant esophageal stenosis and tracheoesophageal fistulas (TEF). However, dysphagia often returns subsequently and repeated endoscopic intervention may be necessary. The aims of the study were to identify the risk factors of complications, and the frequency and efficacy of repeated endoscopic interventions; and to provide technical recommendations on appropriate stent selection. METHODS: We analyzed retrospectively the clinical data of 212 patients with locally advanced esophageal cancer who underwent SEMS implantation...
August 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28828004/feasibility-of-short-period-high-dose-intravenous-methylprednisolone-for-preventing-stricture-after-endoscopic-submucosal-dissection-for-esophageal-cancer-a-preliminary-study
#16
Jun Nakamura, Takuto Hikichi, Ko Watanabe, Masaki Sato, Katsutoshi Obara, Hiromasa Ohira
OBJECTIVE: A wide mucosal defect after endoscopic submucosal dissection (ESD) for esophageal cancer is associated with increased risk of stricture. This study was conducted to evaluate the feasibility of short-period, high-dose intravenous methylprednisolone administration (steroid pulse therapy) in preventing post-ESD esophageal stricture. METHODS: This prospective study examined 13 lesions in 11 consecutive patients with esophageal squamous cell carcinoma who underwent ESD that involved three-quarters or more of the circumference of the esophagus or who had a longitudinal resected specimen diameter of ≥5 cm...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28803528/the-role-of-endoscopy-in-eosinophilic-esophagitis-from-diagnosis-to-therapy
#17
Alfredo J Lucendo, Ángel Arias, Javier Molina-Infante, Laura Arias-González
Eosinophilic esophagitis (EoE) has arisen as a common disorder in current clinical and endoscopic gastroenterology practice. Areas covered: A comprehensive review of the literature to summarize and update different aspects related with the use of endoscopy in the diagnostic workout and treatment of pediatric and adult EoE patients is conducted. Expert commentary: Endoscopic features in EoE are frequently subtle, so were inadverted in some initial reports of the disease. Literature has described a wide number of EoE-associated features, systematized in the EREFS classification, which standardized the grade and severity of exudates, rings, edema, furrows, and strictures...
August 17, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28783923/safe-and-proper-management-of-esophageal-stricture-using-endoscopic-esophageal-dilation
#18
Jae Jin Hwang
No abstract text is available yet for this article.
July 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28763273/diagnosis-and-treatment-of-esophageal-foreign-body-or-stricture-in-three-ferrets-mustela-putorius-furo
#19
Joanna Webb, Jennifer Graham, Margaret Fordham, Julie DeCubellis, Faith Buckley, Joshua Hobbs, Allyson Berent, Chick Weisse
CASE DESCRIPTION 3 ferrets (Mustela putorius furo), aged 1 to 2 years, were referred for evaluation of a 4-day to 2-week history of gastrointestinal signs, including anorexia, regurgitation, and vomiting. CLINICAL FINDINGS All 3 ferrets had clinical signs suggestive of dysphagia or esophagitis on initial examination. Esophagoscopy, barium-contrast esophagography, or both revealed foreign bodies with mucosal inflammation in 1 patient and an esophageal foreign body with stricture in 2 patients. One of the latter ferrets had a recent history of gastrotomy to remove a foreign body...
August 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28762451/esophageal-button-battery-ingestion-in-children
#20
Arzu Şencan, İncinur Genişol, Münevver Hoşgör
BACKGROUND: Button battery lodged in the esophagus carries a high risk of morbidity and mortality. The purpose of this study was to present cases of patients with esophageal button battery ingestion treated at our clinic and to emphasize the importance of early diagnosis and treatment. METHODS: Records of patients admitted to our hospital for foreign body ingestion between January 2010 and May 2015 were retrospectively reviewed. Cases with button battery lodged in the esophagus were included in the study...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
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