- Successful Design and Implementation of a POEM Program for Achalasia in an Integrated Healthcare System. [Journal Article]
- CONCLUSIONS: In this study, we outlined the steps involved to establish a POEM service in a large integrated healthcare system. Prior competency in interventional endoscopy, procedural training models, POEM observation and education, proctorship, and interdisciplinary patient care are recommended.
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- Peroral Endoscopic Myotomy for Achalasia in Older Adults: A Retrospective Analysis of 39 Cases with a Minimum Follow-Up of 5 Years. [Journal Article]Dysphagia. 2023 Feb 01 [Online ahead of print]D
- Peroral endoscopic myotomy (POEM) has demonstrated favorable short-term safety and efficacy in older adults, while a comprehensive understanding of the long-term outcomes were vague. We aimed to evaluate clinical outcomes in older adults' 5-year postop after undergoing POEM to treatment achalasia. Older adults from a single hospital who received POEM between January 2010 and January 2017 were ana…
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- Optimal surgical approaches for esophageal epiphrenic diverticulum: literature review and our experience. [Journal Article]Clin J Gastroenterol. 2023 Feb 01 [Online ahead of print]CJ
- Esophageal epiphrenic diverticulum is a rare condition usually secondary to a primary esophageal motility disorder. Although epiphrenic diverticulum may be treated by thoracoscopic and laparoscopic management, the optimal surgical approach have not been established. We successfully treated a left epiphrenic diverticulum along with achalasia and paraesophageal hernia by a planned combination of th…
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- Post-POEM Contrast-Enhanced Swallow Study: Is It Always Necessary? [Journal Article]J Gastrointest Surg. 2023 Jan 31 [Online ahead of print]JG
- CONCLUSIONS: The study findings suggest that performing routine contrast-enhanced swallow studies on all patients is not necessary following POEM, as leaks can be screened for by clinical or laboratory abnormalities. Herein, we propose an algorithm based on objective measurable findings for the selection of patients who should undergo CESS.
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- Laparoscopic Heller-Dor Is a Persistently Effective Treatment for Achalasia Even in Pediatric Patients: A 25-Year Experience at a Single Tertiary Center. [Journal Article]Eur J Pediatr Surg. 2023 Jan 31 [Online ahead of print]EJ
- CONCLUSIONS: LHD is a safe and persistently effective treatment for EA in pediatric age, with a success rate comparable with what is usually obtained in adults, and better than what has been reported to date in the pediatric literature. Adding a fundoplication certainly helps ensure an optimal long-term control of any gastroesophageal reflux induced by the myotomy.
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- Acupuncture combined with balloon dilation for post-stroke cricopharyngeal achalasia: A meta-analysis of randomized controlled trials. [Systematic Review]
- CONCLUSIONS: Acupuncture combined with balloon dilatation may be an effective method for treating post-stroke CPA. Compared with balloon dilatation, acupuncture combined with balloon can significantly improve the swallowing function of patients, and it is also effective for patients of different courses, ages, and treatment course, while patients over 60 years old and the treatment course over 30 days may have better clinical outcomes.
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- Thoracoscopic approach as surgical management of esophageal epiphrenic diverticulum. [Journal Article]J Visc Surg. 2023 Jan 27 [Online ahead of print]JV
- CONCLUSIONS: Thoracoscopic approach as management of epiphrenic diverticulum is feasible, with acceptable short-term morbidity. The thoracoscopic approach is also effective in resolving preoperative symptoms.
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- Achalasia: investigation and management. [Review]Br J Hosp Med (Lond). 2023 Jan 02; 84(1):1-9.BJ
- Achalasia, characterised by the absence of peristalsis and failure of relaxation of the lower oesophageal sphincter, is an uncommon degenerative condition that results in dysphagia. If left untreated it can lead to aspiration, oesophageal perforation, oesophagitis and malnutrition. It has a range of immune, allergic, viral and genetic aetiological causes. Successful diagnosis relies on the use of…
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- Initial assessment of medical post-traumatic stress among patients with chronic esophageal diseases. [Journal Article]Neurogastroenterol Motil. 2023 Jan 26 [Online ahead of print]NM
- CONCLUSIONS: Preliminary evidence suggests medical PTS affects few patients with esophageal disease. However traumatic procedures, most often associated with HRM, significantly increase PTS symptoms. The potential impacts of medical PTS on esophageal patient assessment and outcomes are considerable and warrants further study.
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- Chagas' disease achalasia may represent a sub-group of type 2 achalasia without focal elevated pressures. [Letter]Neurogastroenterol Motil. 2023 Jan 23 [Online ahead of print]NM
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- TYPE II ACHALASIA WITH SUBSEQUENT RECOVERY OF ESOPHAGEAL MOTILITY - POEM. [Journal Article]Rev Esp Enferm Dig. 2023 Jan 23 [Online ahead of print]RE
- CONCLUSIONS: Achalasia is an esophageal motor disorder characterized by incomplete relaxation of the lower esophageal sphincter and a complete absence of peristalsis in the esophageal body. The cause of the absence of motility is the loss of the inhibitory neurons of the myenteric plexus, but the accurate etiopathogenesis is still unknown. Therefore, there is no curative treatment and all therapeutic options are symptomatic, aimed to relieve the obstruction of the EGJ. POEM is the newest method. Absence of motility of the esophageal body in patients with achalasia was believed to be irreversible. Nevertheless, more and more studies describe a partial recovery of motility observed in manometry after POEM, especially in type II Achalasia. The exact pathophysiological mechanism of this recovery is still unknown.
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- The utility of endoscopic functional luminal imaging (EndoFLIP) in the diagnosis and management of children with achalasia. [Journal Article]J Pediatr Surg. 2022 Dec 22 [Online ahead of print]JP
- CONCLUSIONS: The EndoFLIP system is a valuable tool in adult patients in diagnosing achalasia and defining the endpoint of the POEM procedure. We find that there is a role for EndoFLIP in the pediatric population in diagnosis and management of the disease.
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- Updates in the Field of Submucosal Endoscopy. [Review]
- Submucosal endoscopy (third-space endoscopy) can be defined as an endoscopic procedure performed in the submucosal space. This procedure is novel and has been utilized for delivery to the submucosal space in a variety of gastrointestinal diseases, such as a tumor, achalasia, gastroparesis, and subepithelial tumors. The main submucosal endoscopy includes peroral endoscopic myotomy, gastric peroral…
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- Impact of Hypermannosylation on the Structure and Functionality of the ER and the Golgi Complex. [Journal Article]
- Proteins of the secretory pathway undergo glycosylation in the endoplasmic reticulum (ER) and the Golgi apparatus. Altered protein glycosylation can manifest in serious, sometimes fatal malfunctions. We recently showed that mutations in GDP-mannose pyrophosphorylase A (GMPPA) can cause a syndrome characterized by alacrima, achalasia, mental retardation, and myopathic alterations (AAMR syndrome). …
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- Dysphagia in Children, Do Not Blame Eosinophils Too Quickly. [Case Reports]
- Dysphagia in children is a relatively frequent symptom in childhood, and the main causes are congenital and linked to ear-nose-throat etiologies. However, non-congenital esophageal dysphagia is less common, and the main cause in such cases is eosinophilic esophagitis (EoE). When there is no response to a well-conducted treatment, with normalization of histology, the diagnosis of EoE must then be …
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- Peroral endoscopic myotomy: is it better to perform it in naive patients or as second-line therapy? Results of an open-label-controlled study in 105 patients. [Journal Article]Surg Endosc. 2023 Jan 20 [Online ahead of print]SE
- CONCLUSIONS: Efficacy, feasibility and safety of POEM are not different between treatment-naïve and non-naïve patients. POEM is a valuable second-line approach in patients with persistent symptoms of achalasia after surgical or endoscopic treatments.
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- The possible association between neurodegenerative/demyelinating neurological disorders in achalasia patients. [Journal Article]
- The precise pathogenesis of achalasia is still unclear. Neurodegenerative and/or demyelinating disorders (NDD) appear to share some common pathophysiological pathways described in achalasia such as inflammation, autoimmune, mitochondrial dysfunction, and neurodegeneration. Jerie et al. have published on the October issue a prospective study assessing the prevalence of several NDD in achalasia pat…
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- Probability of additional intervention and long-term follow-up of esophagomyotomy. [Journal Article]Surg Endosc. 2023 Jan 19 [Online ahead of print]SE
- CONCLUSIONS: Our results for both LHM and POEM emphasize the importance of long-term follow-up in patients with an esophageal motility disorder. We have found that patients undergoing LHM are more likely to have a post-operative intervention as well as a higher rate of repeat myotomy than POEM. With both interventions, a greater change in Eckardt score decreased the likelihood of reintervention.
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- Peroral endoscopic myotomy using an endoscopic dissector: another novel device in our toolbox. [Journal Article]
- Video 1Peroral endoscopic myotomy using an endoscopic dissector for achalasia.
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- SHORT TERM OUTCOMES FOLLOWING POEM, HELLER MYOTOMY AND PNEUMATIC DILATION IN PATIENTS WITH ACHALASIA: A NATIONWIDE ANALYSIS. [Journal Article]Gastrointest Endosc. 2023 Jan 10 [Online ahead of print]GE
- CONCLUSIONS: In the United States, the risk of readmission and resource utilization is higher in patients with achalasia undergoing PD. The outcomes are comparable between POEM and LHM but there is a significant difference between the utilization of these myotomy procedures.
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- Peroral endoscopic myotomy for the treatment of achalasia in the Unified Healthcare System (SUS): results of a short-term. [Journal Article]Rev Col Bras Cir. 2023; 49:e20223244.RC
- CONCLUSIONS: clinical improvement of symptoms and the patient profile followed the worldwide trend, with emphasis on the etiology secondary to Chagas disease, endemic in Brazil. Gastroesophageal reflux remains the main post-operative symptom.
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- Three-dimensional laparoscopic approach to distal oesophageal diverticula: Single-centre experience. [Journal Article]J Minim Access Surg. 2023 Jan-Mar; 19(1):120-129.JM
- CONCLUSIONS: 3D laparoscopic diverticulectomy offers a reasonable chance of treatment in patients with epiphrenic diverticula. Optimal selection of patients, optimisation for surgery, gaining the surgical experience of carrying out these techniques and impact on short- and long-term results are issues that still remain under debate.
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- Peroral endoscopic myotomy versus pneumatic dilation in treatment-naive patients with achalasia - Authors' reply. [Letter]Lancet Gastroenterol Hepatol. 2023 Feb; 8(2):114.LG
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- Peroral endoscopic myotomy versus pneumatic dilation in treatment-naive patients with achalasia. [Letter]Lancet Gastroenterol Hepatol. 2023 Feb; 8(2):113-114.LG
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- Prevalence of Different Types of Primary Esophageal Motility Disorders and Their Associated Factors in Patients Referring to Shariati Hospital during 2018-2019. [Journal Article]
- BACKGROUND: Esophageal motility disorders (EMDs) are common in patients with dysphagia and are effectively diagnosed with high-resolution manometry (HREM). In this study, we aimed to evaluate the prevalence of different types of primary EMDs in patients referred for HREM and to further investigate the factors associated with EMDs. METHODS: In this cross-sectional study, all patients referred to t…
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- Publication trends of peroral endoscopic myotomy during 2010-2022: a bibliometric analysis. [Journal Article]
- CONCLUSIONS: Researchers from the United States, China, and Japan have published the most articles in the field of POEM research, but there was a disparity between the quantity and quality of publications. Research of management and POEM-derived novel techniques were considered potential areas of focus for future research.
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- Submucosal endoscopy: the present and future. [Review]Clin Endosc. 2023 Jan; 56(1):23-37.CE
- Submucosal endoscopy or third-space endoscopy utilizes the potential space between the mucosal and muscularis layers of the gastrointestinal tract to execute therapeutic interventions for various diseases. Over the last decade, endoscopic access to the submucosal space has revolutionized the field of therapeutic endoscopy. Submucosal endoscopy was originally used to perform endoscopic myotomy in …
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- Downexpression of miR-200c-3p Contributes to Achalasia Disease by Targeting the PRKG1 Gene. [Journal Article]
- Achalasia is an esophageal smooth muscle motility disorder with unknown pathogenesis. Taking into account our previous results on the downexpression of miR-200c-3p in tissues of patients with achalasia correlated with an increased expression of PRKG1, SULF1, and SYDE1 genes, our aim was to explore the unknown biological interaction between these genes and human miR-200c-3p and if this relation co…
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- Influence of Anxiety and Depression on the Symptoms of Achalasia Patients: A Retrospective Cohort Study in China during COVID-19. [Journal Article]Dig Dis. 2023 Jan 05 [Online ahead of print]DD
- CONCLUSIONS: The outbreak of COVID-19 made AC patients and healthy people anxious and depressed. Depression rather than anxiety might worsen the AC symptoms. Interventional therapy might protect AC patients against psychological abnormalities during COVID-19.
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