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Esophageal dilation endoscopic

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https://www.readbyqxmd.com/read/27878898/feasibility-and-safety-of-peroral-endoscopic-myotomy-for-achalasia-after-failed-endoscopic-interventions
#1
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/27862613/naso-esophageal-extraluminal-drainage-for-postoperative-anastomotic-leak-after-thoracic-esophagectomy-for-patients-with-esophageal-cancer
#2
Kiyohiko Shuto, Tsuguaki Kono, Yasunori Akutsu, Masaya Uesato, Mikito Mori, Kenichi Matsuo, Chihiro Kosugi, Atsushi Hirano, Kuniya Tanaka, Shinich Okazumi, Keiji Koda, Hisahiro Matsubara
Postoperative anastomotic leaks and subsequent mediastinal abscess are serious complications. The purpose of this study was to assess the efficacy of naso-esophageal extraluminal drainage after thoracic esophagectomy with gastric conduit reconstruction using a posterior mediastinal route. About 50 of 365 patients (13.7%) with esophageal cancer and postoperative anastomotic leak after curative esophagectomy was investigated. Beginning in June 2009, naso-esophageal extraluminal drainage by inserting a naso-esophageal aspiration tube into the abscess cavity when percutaneous abscess drainage was introduced which was ineffective or technically impossible...
November 9, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27853736/transplantation-of-epidermal-cell-sheets-by-endoscopic-balloon-dilatation-to-avoid-esophageal-re-strictures-initial-experience-in-a-porcine-model
#3
Shinichiro Kobayashi, Nobuo Kanai, Nobuyuki Tanaka, Masanori Maeda, Takahiro Hosoi, Fumio Fukai, Susumu Eguchi, Masayuki Yamato
Background and study aims: Epidermal cell sheet (ECS) transplantation immediately after aggressive endoscopic submucosal dissection (ESD) has been shown to be safe and effective in the prevention of esophageal strictures. This study evaluated the feasibility of ECS transplantation after endoscopic balloon dilation (EBD) in a porcine model. Methods: Six pigs underwent circumferential esophageal ESD under general anesthesia. Two weeks later, two pigs underwent EBD and transplantation of an autologous ECS, two underwent EBD alone, and two underwent endoscopic observation only (control)...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27835929/endoscopic-treatment-of-benign-esophageal-strictures-a-literature-review
#4
Laurent Poincloux, Olivier Rouquette, Armand Abergel
Benign esophageal strictures arise from various etiologies and are frequently encountered. Although endoscopic dilation is still the first-line therapy, recurrent strictures do occur in approximately 10% of the cases and remains a challenge to gastroenterologists. Areas covered: A literature search was performed using PubMed and Google Scholar databases for original and review articles on endoscopic treatment of benign esophageal strictures. This review outlines the main available treatment options and its controversies in the management of refractory benign esophageal strictures...
November 11, 2016: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27818585/update-on-the-endoscopic-treatments-for-achalasia
#5
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/27812392/periesophageal-pseudoaneurysms-rare-cause-of-refractory-bleeding-treated-with-transarterial-embolization
#6
Divyanshoo R Kohli, Rachit D Shah, Daniel J Komorowski, George B Smallfield
A 43-year-old female with history of systemic lupus erythematosus, prior cytomegalovirus esophagitis treated with ganciclovir, and long segment Barrett's esophagus (Prague class C8 M9) with high grade dysplasia treated with radiofrequency ablation presented to the hospital with hematemesis. An upper gastrointestinal endoscopy showed multiple esophageal ulcers with active arterial spurting which could not be controlled with endoscopic interventions including placement of hemostatic clips. An emergent angiogram demonstrated actively bleeding saccular dilations (pseudoaneurysms) in the esophageal branches of the lower thoracic aorta as well as left gastric artery for which gelfoam and coil embolization was initially successful...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27778205/association-between-body-mass-index-and-clinical-and-endoscopic-features-of-eosinophilic-esophagitis
#7
W Asher Wolf, Nicholas A Piazza, Jessica H Gebhart, Spencer Rusin, Shannon Covey, Leana L Higgins, RoseMary Beitia, Olga Speck, Kimberly Woodward, Cary C Cotton, Thomas M Runge, Swathi Eluri, John T Woosley, Nicholas J Shaheen, Evan S Dellon
BACKGROUND: Because eosinophilic esophagitis (EoE) causes dysphagia, esophageal narrowing, and strictures, it could result in low body mass index (BMI), but there are few data assessing this. AIM: To determine whether EoE is associated with decreased BMI. METHODS: We conducted a prospective study at the University of North Carolina from 2009 to 2013 enrolling consecutive adults undergoing outpatient EGD. BMI and endoscopic findings were recorded...
October 24, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27775286/-cricopharyngeal-achalasia-diagnosis-and-therapeutic-alternatives
#8
P Rodríguez Iglesias, V Ibáñez Pradas, A Alamar Velázquez, I Ibáñez Alcañiz, M Couselo Jerez
INTRODUCTION: The cricopharyngeal achalasia is an esophageal motor disorder that entails a lack of relaxation of the upper esophageal sphincter. It is rare in children and its etiology is related to multiple factors. The symptoms are nonspecific and may be masked by other diseases. CLINICAL CASE: Report two infants with dysphagia and choking episodes. Upper gastrointestinal series confirmed cricopharyngeal achalasia. The first patient was treated with endoscopic dilatation, and did not require further therapies...
April 15, 2015: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27747281/first-reports-of-esophageal-adenocarcinoma-with-white-globe-appearance-in-japanese-and-caucasian-patients
#9
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
https://www.readbyqxmd.com/read/27745759/-eosinophilic-esophagitis
#10
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
https://www.readbyqxmd.com/read/27706459/long-term-postoperative-endoscopic-findings-after-gastric-bypass-procedure-a-co-occurrence-analysis
#11
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
https://www.readbyqxmd.com/read/27695356/managing-eosinophilic-esophagitis-challenges-and-solutions
#12
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
https://www.readbyqxmd.com/read/27664425/can-mitomycin-facilitate-endoscopic-dilatation-treatment-of-benign-oesophageal-stricture
#13
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
https://www.readbyqxmd.com/read/27663714/long-term-outcomes-of-per-oral-endoscopic-myotomy-in-achalasia-patients-with-a-minimum-follow-up-of-2-years-an-international-multicenter-study
#14
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
https://www.readbyqxmd.com/read/27658906/identification-of-volumetric-laser-endomicroscopy-features-predictive-for-early-neoplasia-in-barrett-s-esophagus-using-high-quality-histological-correlation
#15
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
https://www.readbyqxmd.com/read/27652294/hybrid-therapy-with-locoregional-steroid-injection-and-polyglycolic-acid-sheets-to-prevent-stricture-after-esophageal-endoscopic-submucosal-dissection
#16
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
https://www.readbyqxmd.com/read/27649008/minimally-invasive-esophagectomy-for-caustic-ingestion-after-73-years-and-over-200-endoscopic-dilations-is-it-just-a-matter-of-time
#17
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
https://www.readbyqxmd.com/read/27636145/large-balloon-dilation-treatment-for-retrieval-of-embedded-sharp-pointed-objects-in-the-esophagus-a-new-technique
#18
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
https://www.readbyqxmd.com/read/27625387/diagnosis-and-management-of-esophageal-achalasia
#19
REVIEW
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...
September 13, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27612924/per-oral-endoscopic-tunneling-for-restoration-of-the-esophagus-a-novel-endoscopic-submucosal-dissection-technique-for-therapy-of-complete-esophageal-obstruction
#20
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
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