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https://www.readbyqxmd.com/read/27916166/recurrence-after-surgery-in-esophago-gastric-junction-adenocarcinoma-current-management-and-future-perspectives
#1
Alessandro Neri, Daniele Marrelli, Costantino Voglino, Giulio Di Mare, Francesco Ferrara, Mario Marini, Franco Roviello
Recurrent esophago-gastric junction adenocarcinoma is not a rare event and its correct management is still debated. Many approaches for the treatment of these patients exist, but only few studies compare the different techniques. Most of the studies are retrospectives series and describe the experiences of single institutions in the treatment of recurrent esophageal and esophago-gastric junction cancers. Nowadays surgery is still the main and only curative treatment. Other alternative palliative therapies could be endoscopic stent placement and balloon dilation, photodynamic therapy, thermal tumor ablation (laser photoablation and Argon plasma coagulation), radiation therapy and brachytherapy, and chemotherapy...
December 2016: Surgical Oncology
https://www.readbyqxmd.com/read/27878898/feasibility-and-safety-of-peroral-endoscopic-myotomy-for-achalasia-after-failed-endoscopic-interventions
#2
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/27865290/pneumatic-dilation-of-the-lower-esophageal-sphincter-can-now-be-successfully-performed-without-morbidity
#3
Yi Jia, Marco Bustamante, Sharareh Moraveji, Richard W McCallum
BACKGROUND: Patients with dysphagia may be diagnosed with impaired lower esophageal sphincter (LES) relaxation and treated with pneumatic dilation (PD), stretching and tearing LES muscle fibers. Esophageal perforation has been reported to be as high as 10%. We conducted a retrospective study to evaluate the perforation rate of PD when used for impaired relaxation of the LES using current techniques. METHODS: A chart review was conducted to identify patients referred for esophageal manometry by high-resolution manometry and later received PD from January 2013 to April 2016...
November 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27862613/naso-esophageal-extraluminal-drainage-for-postoperative-anastomotic-leak-after-thoracic-esophagectomy-for-patients-with-esophageal-cancer
#4
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
#5
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/27758725/-dysphagia-in-children
#6
E Ten Velde, B C Gonera-de Jong
In this case report we discuss two children with dysphagia. Both presented with difficulties in swallowing and oesophageal impaction of solid food. The first case involves a 16-year-old boy who suffered from dysphagia for many years. After a long diagnostic journey, during which a psychogenic cause was suspected, he was diagnosed with oesophageal achalasia. After a balloon dilatation of the lower oesophageal sphincter his complaints persisted and the treatment procedure was repeated. The second case involves a 15-year-old girl, who presented with a food impaction in the distal oesophagus...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27652294/hybrid-therapy-with-locoregional-steroid-injection-and-polyglycolic-acid-sheets-to-prevent-stricture-after-esophageal-endoscopic-submucosal-dissection
#7
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/27636145/large-balloon-dilation-treatment-for-retrieval-of-embedded-sharp-pointed-objects-in-the-esophagus-a-new-technique
#8
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
#9
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/27585471/endoscopic-dilation-of-benign-esophageal-anastomotic-strictures-over-16%C3%A2-mm-has-a-longer-lasting-effect
#10
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
https://www.readbyqxmd.com/read/27553792/impact-of-prior-interventions-on-outcomes-during-per-oral-endoscopic-myotomy
#11
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
https://www.readbyqxmd.com/read/27515392/an-intractable-caustic-esophageal-stricture-successfully-managed-with-sequential-treatment-comprising-incision-with-an-insulated-tip-knife-balloon-dilation-and-an-oral-steroid
#12
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...
November 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27506393/non-adherence-to-the-rule-of-3-does-not-increase-the-risk-of%C3%A2-adverse-events-in-esophageal-dilation
#13
Karina V Grooteman, Louis M Wong Kee Song, Frank P Vleggaar, Peter D Siersema, Todd H Baron
BACKGROUND AND AIMS: Although the rule of 3 is recommended to minimize the risk of perforation when esophageal dilation is performed using bougie dilators, there are no data to validate its use. Our aim was to investigate the association between the rule of 3 and adverse events (AEs) in esophageal dilation. METHODS: A retrospective chart review in patients who underwent esophageal bougie or balloon dilation between December 1991 and February 2013 at a tertiary hospital was performed...
August 6, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27501729/mucosal-perforation-during-laparoscopic-surgery-for-achalasia-impact-of-preoperative-pneumatic-balloon-dilation
#14
Yoshihito Souma, Kiyokazu Nakajima, Eiji Taniguchi, Tsuyoshi Takahashi, Yukinori Kurokawa, Makoto Yamasaki, Yasuhiro Miyazaki, Tomoki Makino, Tetsuhiro Hamada, Jun Yasuda, Takeyoshi Yumiba, Shuichi Ohashi, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
BACKGROUND: Controversy remains whether preoperative pneumatic balloon dilation (PBD) influences the surgical outcome of laparoscopic esophagocardiomyotomy in patients with esophageal achalasia. The aim of this study was to evaluate whether preoperative PBD represents a risk factor for surgical complications and affects the symptomatic and/or functional outcomes of laparoscopic Heller myotomy with Dor fundoplication (LHD). METHODS: A retrospective chart review was conducted on a prospectively compiled surgical database of 103 consecutive patients with esophageal achalasia who underwent LHD from November 1994 to September 2014...
August 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27469501/steroid-pulse-therapy-prevents-restenosis-following-balloon-dilatation-for-esophageal-stricture
#15
Kazuki Yokota, Hiroo Uchida, Akihide Tanano, Chiyoe Shirota, Takahisa Tainaka, Akinari Hinoki, Naruhiko Murase, Kazuo Oshima, Ryo Shirotsuki, Kosuke Chiba
PURPOSE: This study aimed to evaluate the effectiveness of intravenous steroid pulse therapy following balloon dilatation for esophageal stenosis and stricture in children. METHODS: The study enrolled six children, including three with congenital esophageal stenosis and three with anastomotic strictures after surgery for esophageal atresia, all of whom were treated by balloon dilatation combined with high-dose intravenous methylprednisolone pulse therapy. Methylprednisolone was injected intravenously at a dose of 20 mg/kg/day for 2 days, starting from the day of dilatation, followed by 10 mg/kg/day for 2 days, for a total of 4 days...
September 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27443493/topical-mitomycin-c-application-in-the-treatment-of-refractory-benign-esophageal-strictures-in-adults-and-comprehensive-literature-review
#16
Michael J Bartel, Kristina Seeger, Kayin Jeffers, Donnesha Clayton, Michael B Wallace, Massimo Raimondo, Timothy A Woodward
BACKGROUND: Recurrent complex esophageal strictures remain difficult to manage. AIMS: To determine the efficacy of topical Mitomycin C application for recurrent benign esophageal strictures. METHODS: All patients who underwent balloon dilation followed by topical Mitomycin C application for recurrent benign esophageal strictures were included. Primary outcome was number of dilations and change of dysphagia score. RESULTS: Nine patients with anastomotic (3), radiation-induced (3), caustic (2), and combined anastomotic and radiation-induced (1) strictures were included...
September 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27423892/managing-esophageal-dysphagia-in-the-elderly
#17
REVIEW
Felice Schnoll-Sussman, Philip O Katz
Esophageal dysphagia in the elderly is a common clinical problem. Achalasia is a disease in which there is loss of ganglion in the myenteric plexus of the lower esophageal sphincter resulting in incomplete relaxation of that muscle causing a functional obstruction to outflow. Treatment is aimed at reducing sphincter pressure allowing for gravity and the oral portion of the swallow to propel the bolus through the esophagus. Pneumatic dilatation, Heller myotomy (laparoscopic), and the newest procedure peroral endoscopic esophageal myotomy (POEM) are all reasonable options for effective treatment even in the elderly...
September 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27401049/efficacy-of-pneumodilation-in-achalasia-after-failed-heller-myotomy
#18
C M G Saleh, F A M Ponds, M P Schijven, A J P M Smout, A J Bredenoord
BACKGROUND: Heller myotomy is an effective treatment for the majority of achalasia patients. However, a small proportion of patients suffer from persistent or recurrent symptoms after surgery and they are usually subsequently treated with pneumodilation (PD). Data on the efficacy of PD as secondary treatment for achalasia are scarce. Therefore, this study aimed to investigate the efficacy of PD as treatment for achalasia patients suffering from persistent or recurrent symptoms after Heller myotomy...
July 11, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27391311/kindler-syndrome-a-case-of-two-iranian-sisters
#19
Saeed Kargar, Seyed M Shiryazdi, Hossein Neamatzadeh, V Ramazani
Kindler syndrome is a rare autosomal recessive condition, characterized by multiple skin and mucosal abnormalities. Among the latter, esophageal involvement is an infrequent manifestation which may be completely asymptomatic or complicate with dysphagia. We report two sisters presenting with cutaneous features and severe dysphagia. Endoscopic examination showed that the patients were affected with a rare condition named esophageal web. Both patients showed much improvement after balloon dilation. Clinicians should be aware of the potential disease complications and balloon dilation approach should be considered as primary therapy in the Kindler syndrome patients with esophageal web...
July 8, 2016: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/27382696/-stent-implantation-in-the-treatment-of-pharynx-anastomotic-stenosis-after-cervical-esophageal-resection-a-case-report
#20
Chuanshan Zang, Jian Sun, Yan Sun
We report the treatment of one patient with pharynx anastomotic stenosis after cervical esophagealresection by stent implantation. The patient suffered from serious pharynx anastomotic stenosis after gastric-pha-ryngeal anastomosis. After balloon-dilatation,a domestic self-expanding Z-stents was implanted in the stricture ofthe esophagus under the X-rays. After stent implantation, the patient has been leading a normal life for threeyears. Balloon dilatation and stent implantation is an effective and safe method in the treatment of patients withpharynx anastomotic stenosis...
March 2016: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
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