Outcomes of Heller Myotomy for ESOPHAGEALAchalasia: Lessons from a 48-YEAR PROSPECTIVE Experience with four Different Techniques. to provide information on long-term outcomes of Heller myotomy for esophagealachalasia with or without an antireflux fundoplication. Since the adoption of the Heller myotomy, surgeons have modified the original technique in order to balance the cure of dysphagia in 3/155 (1.93%). Erosive-ulcerative esophagitis was diagnosed for AM in 28.16%, for TM in 30%, for L-HD in 8.45%, for VL-HD in 2.58%. Overall, the outcome was satisfactory in 52.11% for AM, 41.9% for TM, 89.05% for L-HD, 96.12% for VL-HD. The Dor fundoplication drastically reduces post myotomy gastro-esophageal reflux. The Heller-Dor operation is a competitive option for the cure of esophageal
Peroral endoscopic myotomy vs laparoscopic myotomy and partial fundoplication for esophagealachalasia: A single-center randomized controlled trial. Achalasia is a rare benign esophageal motor disorder characterized by incomplete relaxation of the lower esophageal sphincter (LES). The treatment of achalasia is not curative, but rather is aimed at reducing LES pressure. In patients who have
EsophagealAchalasia: Pros and Cons of the Treatment Options. Achalasia is a primary esophageal motility disorder of unknown origin. The goal of treatment is to reduce the resistance caused by a lower esophageal sphincter that fails to relax and is frequently hypertensive. Many treatment options are available to achieve this goal. In this review, we discuss the pros and cons of each therapeutic
The Evolution of the Treatment of EsophagealAchalasia: From the Open to the Minimally Invasive Approach. Achalasia is a primary esophageal motility disorder characterized by lack of esophageal peristalsis and partial or absent relaxation of the lower esophageal sphincter in response to swallowing. This study aimed to provide an overview of the evolution of the surgical treatment for esophageal the esophagomyotomy was done with either an open transthoracic or transabdominal approach. With the advancements of minimally invasive surgery, thoracoscopic and laparoscopic operations became available. The ability to add a fundoplication for the prevention of reflux made the laparoscopic Heller myotomy with partial fundoplication the operation of choice. Surgical management of esophagealachalasia has
EsophagealAchalasia: Evaluation and Treatment of Recurrent Symptoms. Esophagealachalasia is a primary esophageal motility disorder of unknown origin. Treatment is palliative and its goal is to decrease the resistance posed by a non-relaxing and often hypertensive lower esophageal sphincter. This goal can be accomplished by different treatment modalities such as pneumatic dilatation
EsophagealAchalasia: Diagnostic Evaluation. A precise diagnosis is key to the successful treatment of achalasia. Barium swallow, upper endoscopy and high-resolution manometry provide the necessary information about a patient's anatomy, absence of other diseases, and type of achalasia (I, II, III). High-resolution manometry also has prognostic value, the best results of treatment being obtained
Comparison of Endoscopic Dilatation and Heller's Myotomy for Treating EsophagealAchalasia in Children: A Multicenter Study. To compare the efficacy of, and complications from, the 2 main treatments for achalasia: endoscopic dilatation and surgical cardiomyotomy (Heller's myotomy). We retrospectively collected data on children treated for achalasia over an 11-year period from 8 tertiary
Per oral endoscopic myotomy (POEM) in pediatric patients with esophagealachalasia: First Latin-American experience. Achalasia is the most common primary motor disorder of the esophagus, but its incidence in pediatric patients is low. Laparoscopic Heller myotomy (LHM) is the current surgical standard of care treatment. Per-oral endoscopic myotomy (POEM) has emerged as a safe and effective therapeutic alternative in adult patients. We herein report the outcomes of a cohort of pediatric patients with achalasia treated by POEM at a Chilean medical center. This is a retrospective analysis of prospectively collected data on children who underwent POEM for esophagealachalasia. Clinical follow-up was evaluated by recording the Eckardt score, a high-resolution esophageal manometry (HREM) three
Poem Versus Laparoscopic Heller Myotomy in the Treatment of EsophagealAchalasia: A Case-Control Study from Two High Volume Centers Using the Propensity Score. POEM has recently had a widespread diffusion, aiming at being the treatment of choice for esophagealachalasia. The results of ongoing RCTs against laparoscopic myotomy are not available, yet. We, therefore, designed this propensity score
Gastric myotomy length affects severity but not rate of post-procedure reflux: 3-year follow-up of a prospective randomized controlled trial of double-scope per-oral endoscopic myotomy (POEM) for esophagealachalasia. Since Inoue performed the first POEM in 2008, safety and efficacy have been well-established. Early studies focused on refining the technique and avoiding incomplete myotomy
Multicenter collaborative retrospective evaluation of peroral endoscopic myotomy for esophagealachalasia: analysis of data from more than 1300 patients at eight facilities in Japan. Peroral endoscopic myotomy (POEM) is a novel, minimally invasive treatment for esophagealachalasia. We retrospectively examined and evaluated the results following POEM to verify the technique's efficacy and safety as the first-line and standard treatment for esophagealachalasia.
Management of EsophagealAchalasia after Roux-en-Y Gastric Bypass: Narrative Review of the Literature. The development of achalasia after Roux-en-Y gastric bypass (RYGB) is rare. Heller myotomy (HM) is the gold standard treatment while peroral endoscopic myotomy (POEM) is an emerging technique with promising results. The aim of this narrative review was to summarize the current knowledge on the treatment of esophagealachalasia after RYGB. PubMed, EMBASE, and Web of Science databases were consulted. All articles that described the management of achalasia after RYGB were included in this narrative review. Twelve studies for a total of 28 patients were included. The age of the patient population ranged from 44 to 70 years old and 80% were females. Overall, 61.5% underwent laparoscopic RYGB while
Population-based cohort study of surgical myotomy and pneumatic dilatation as primary interventions for oesophagealachalasia. The aim of this national population-based cohort study was to compare rates of reintervention after surgical myotomy versus sequential pneumatic dilatation for the primary management of oesophagealachalasia. Patients with oesophagealachalasia diagnosed between 2002 and 2012, and without an intervention in the preceding 5 years were identified from the Hospital Episode Statistics database. Patients were divided into two groups based on the primary treatment, and propensity score matching was used to compensate for differences in baseline characteristics. Some 14 705 patients were diagnosed with oesophagealachalasia, of whom 7487 (50·9 per cent) received
A Thousand and One Laparoscopic Heller Myotomies for EsophagealAchalasia: a 25-Year Experience at a Single Tertiary Center. The aim of this study was to assess the long-term outcome of laparoscopic Heller-Dor (LHD) myotomy to treat achalasia at a single high-volume institution in the past 25 years. Patients undergoing LHD from 1992 to 2017 were prospectively registered in a dedicated database
Obstructive bronchitis and recurrent pneumonia in esophagealachalasia in a child: A CARE compliant case report. Esophagealachalasia is characterized by impaired relaxation of the cardia and dilation of the intrathoracic part of the esophagus. We describe the late presentation of achalasia in an 11-year old girl. She suffered from recurrent pneumonia, obstructive bronchitis, and problems
Trypanosoma cruzi Detection in Colombian Patients with a Diagnosis of EsophagealAchalasia. Achalasia is a motility disorder of the esophagus that might be secondary to a chronic infection. Several studies have investigated esophagealachalasia in patients with Chagas disease (CD) in Latin America, but no related studies have been performed in Colombia. The goals of the present study were to determine the presence of anti- antibodies in patients with esophagealachalasia who visited a referral hospital in Bogotá, Colombia, and to detect the presence of the parasite and its discrete typing units (DTUs). This cross-sectional study was conducted in adult patients (18-65 years old) who were previously diagnosed with esophagealachalasia and from whom blood was drawn to assess
Diagnosis and management of esophagealachalasia. 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
EVALUATION OF ESOPHAGEALACHALASIA: FROM SYMPTOMS TO THE CHICAGO CLASSIFICATION The diagnosis of achalasia may be suggested by clinical features but a complete work-up is required not only to confirm the diagnosis but also to grade the disease by severity or clinical subtype. To review the current evaluation of esophagealachalasia and its correct comprehension. The literature review was based on papers published on Medline/Pubmed, SciELO and Lilacs, crossing the following headings: "esophagealachalasia"; "deglutition disorders"; "diagnostic techniques", "digestive system"; "endoscopy, digestive system"; "manometry". The diagnosis of achalasia is suggested by clinical features but is not sufficient to distinguish this from other esophageal disease. It must be confirmed by further diagnostic
Esophagography in Patients With EsophagealAchalasia Diagnosed With High-resolution Esophageal Manometry High-resolution esophageal manometry (HREM) is considered to be the gold standard for the diagnosis of achalasia. However, the Japan Esophageal Society recommends that esophagography is also accurate in either diagnosing or excluding the disorder. Accordingly, we compared the efficacy %, 88.0%, and 83.0%, respectively. Patients with type III achalasia had significantly lower physical QOL score than those with type I or II achalasia. Although the mental QOL score in patients with type III achalasia tended to decrease compared with that in patients with type I and II achalasia, the difference was not statistically significant. Diagnosing esophagealachalasia by using esophagography