Database : MEDLINE
Search on : esophageal and motility and disorders [Words]
References found : 3147 [refine]
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[PMID]: 29519608
[Au] Autor:Schneider R; Lazaridis I; Kraljevic M; Beglinger C; Wölnerhanssen B; Peterli R
[Ad] Address:Department of Surgery, St. Claraspital AG, Basel, Switzerland. Electronic address: romano.schneider@claraspital.ch.
[Ti] Title:The impact of preoperative investigations on the management of bariatric patients; results of a cohort of more than 1200 cases.
[So] Source:Surg Obes Relat Dis;, 2018 Jan 12.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Despite the increasing use of bariatric surgery as the most effective treatment of morbid obesity, there is still no consensus on its preoperative diagnostic workup. The aim of this study was to identify the pathologies of the endoscopic and radiologic investigations before performing bariatric surgery and to evaluate their impact on the patient management. METHODS: Retrospective analysis of prospectively collected data of 1225 consecutive patients who underwent laparoscopic Roux-en-Y gastric bypass (n = 834) or sleeve gastrectomy (n = 391) at our institution. An abdominal ultrasound was performed in 1188 patients, 1190 patients underwent upper gastrointestinal (GI) endoscopy, 1178 patients underwent upper GI series, and 610 patients underwent esophageal manometry. SETTING: Private hospital, Switzerland. RESULTS: Gallstones were detected in 222 (21.0%) patients, and a synchronous cholecystectomy was performed in 220 (18.0%) patients. The upper GI series indicated hiatal hernias in 325 (27.6%) patients. The most common findings of the upper GI endoscopy were type-C gastritis (224 patients, 18.8%), reflux esophagitis (229 patients, 19.2%), Helicobacter pylori-positive gastritis (158, 13.3%), and hiatal hernia (55 patients, 4.6%). Additionally, we detected 1 Barrett's high-grade dysplasia, 2 Barrett's carcinomas, and 1 stomach cancer in asymptomatic patients, who were scheduled to have a sleeve gastrectomy. Esophageal motility disorders were detected in 104 (17.0%) individuals, who underwent esophageal manometry. CONCLUSIONS: We recommend performing abdominal sonography and upper GI endoscopy before bariatric surgery as they reveal findings, which influence the therapeutic approach. Upper GI series and esophageal manometry help to define patients not suitable for sleeve gastrectomy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  2 / 3147 MEDLINE  
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[PMID]: 29208537
[Au] Autor:Liu Z; Zhang X; Zhang W; Zhang Y; Chen W; Qin W; Hu J; Cai M; Zhou P; Li Q
[Ad] Address:Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
[Ti] Title:Comprehensive Evaluation of the Learning Curve for Peroral Endoscopic Myotomy.
[So] Source:Clin Gastroenterol Hepatol;, 2017 Dec 05.
[Is] ISSN:1542-7714
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND & AIMS: Peroral endoscopic myotomy (POEM) is a minimally invasive endoscopic surgical procedure that is effective in treatment for spastic esophageal motility disorders. However, little is known about the learning curve for endoscopists. We aimed to evaluate the effects of various factors on the POEM learning curve. METHODS: We performed a retrospective study of 1346 patients who underwent POEM for achalasia at Shanghai Zhongshan Hospital in China from August 2010 through July 2015. We used risk-adjusted cumulative sum and moving average methods to evaluate outcomes. The primary outcome was a composite of technical failure and adverse events. Secondary outcomes included procedure time and the composite outcome of technical failure, adverse events, and clinical failure of the first 192 cases performed by only the original, training surgeon. RESULTS: The primary composite outcome occurred in 54 (4%) of the 1346 patients: 10 technical failures and 44 adverse events. This composite outcome was independently associated with the case number (P = .010), full-thickness myotomy (P = .002), and procedure time (P = .001). After we adjusted for these risk factors, cumulative sum analysis showed that the primary composite outcome decreased gradually after 100 cases. The procedure time was high during the first few cases and decreased after endoscopists performed 70 cases. The secondary composite outcome of technical failure, adverse events, and clinical failure for the 192 cases performed by only the original surgeon gradually decreased after 90-100 cases. CONCLUSIONS: In a retrospective analysis of POEM procedures, we found that 100 cases were required to decrease the risk of technical failure, adverse events, and clinical failure (the learning curve). Seventy cases can be considered the threshold for decreasing procedure time.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher

  3 / 3147 MEDLINE  
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[PMID]: 29509541
[Au] Autor:Gîndea C; Constantin A; Hoara P; Caragui A; AlKadour A; Constantinoiu S
[Ti] Title:Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania.
[So] Source:Chirurgia (Bucur);113(1):144-155, 2018 Jan-Feb.
[Is] ISSN:1221-9118
[Cp] Country of publication:Romania
[La] Language:eng
[Ab] Abstract:Thoracic esophageal diverticulum is a rare pathology frequently associated with esophageal motility disorders. Surgery is the only option in patients with severe symptoms. METHOD: This is a retrospective case series study of 10 patients who underwent diverticulectomy for thoracic (epiphrenic or mid-esophageal) diverticula. It was recorded: main preoperative symptoms, usual blood tests, barium swallow, upper endoscopy and esophageal manometry. We analyzed the postoperative complications, length of stay in hospital and intensive care unit. Most patients presented with regurgitation and/or dysphagia. The surgical approach was through left thoracotomy or abdominal for epiphrenic diverticula and through right thoracotomy or thoracoscopy for mid-esophageal diverticula. 4 patients had severe complications: 3 had major leaks (one death) and one had chylothorax. DISCUSSIONS: Surgery for thoracic diverticula is associated with high mortality and morbidity rates. Leak from the suture line is the most common complication, unlike chylothorax which is a rare complication. Thoracic diverticula represent a benign pathology which can have "žmalignant" postoperative complications. A thorough preoperative work-up is mandatory for choosing the appropriate surgical technique. Use of multiple cartridges for stapling suture increase the risk of leakage, but oversewing the suture may diminish it.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:In-Data-Review

  4 / 3147 MEDLINE  
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[PMID]: 29406039
[Au] Autor:Chedid V; Rosenblatt E; Gandhi KK; Dhalla S; Nandwani MC; Stein EM; Clarke JO
[Ad] Address:Department of Internal Medicine, Division of Gastroenterology & Hepatology, Mayo Clinic Rochester, Rochester, Minnesota. Electronic address: chedid.victor@mayo.edu.
[Ti] Title:The Effect of Race in Patients with Achalasia Diagnosed With High-Resolution Esophageal Manometry.
[So] Source:Am J Med Sci;355(2):126-131, 2018 Feb.
[Is] ISSN:1538-2990
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The advent of the Chicago Classification for esophageal motility disorders allowed for clinically reproducible subgrouping of patients with achalasia based on manometric phenotype. However, there are limited data with regards to racial variation using high-resolution esophageal manometry (HREM). The aim of our study was to evaluate the racial differences in patients with achalasia diagnosed with HREM using the Chicago Classification. We evaluated the clinical presentation, treatment decisions and outcomes between blacks and non-blacks with achalasia to identify potential racial disparities. MATERIALS AND METHODS: We performed a retrospective review of consecutive patients referred for HREM at a single tertiary referral center from June 2008 through October 2012. All patients diagnosed with achalasia on HREM according to the Chicago Classification were included. Demographic, clinical and manometric data were abstracted. All studies interpreted before the Chicago Classification was in widespread use were reanalyzed. Race was defined as black or non-black. Patients who had missing data were excluded. Proportions were compared using chi-squared analysis and means were compared using the Student's t-test. RESULTS: A total of 1,268 patients underwent HREM during the study period, and 105 (8.3%) were manometrically diagnosed with achalasia (53% female, mean age: 53.8 ± 17.0 years) and also met the aforementioned inclusion and exclusion criteria. A higher percentage of women presented with achalasia in blacks as compared to whites or other races (P < 0.001). Non-blacks were more likely to present with reflux than blacks (P = 0.01), while blacks were more likely to be treated on the inpatient service than non-blacks (P < 0.001). There were no other significant differences noted in clinical presentation, treatment decisions and treatment outcomes among blacks and non-blacks. CONCLUSIONS: Our study highlights possible racial differences between blacks and non-blacks, including a higher proportion of black women diagnosed with achalasia and most blacks presenting with dysphagia. There is possibly a meaningful interaction of race and sex in the development of achalasia that might represent genetic differences in its pathophysiology. Further prospective studies are required to identify such differences.
[Mh] MeSH terms primary: African Americans
Esophageal Achalasia/diagnosis
Esophageal Achalasia/physiopathology
Esophageal Achalasia/therapy
European Continental Ancestry Group
[Mh] MeSH terms secundary: Female
Humans
Male
Manometry
Middle Aged
Retrospective Studies
Sex Factors
[Pt] Publication type:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180207
[St] Status:MEDLINE

  5 / 3147 MEDLINE  
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[PMID]: 29465580
[Au] Autor:Höhne S; Hesse V
[Ti] Title:Standard values for gas-perfusion manometry of the esophagus.
[So] Source:Medicine (Baltimore);97(8):e9910, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The manometry with water-perfused or solid-state catheters is the predominant diagnostic procedure to detect motility disorders of the esophagus. Another method is the manometry using gas-perfused catheters. Although the high-resolution manometry is the method of first choice, the conventional manometry with helium has some advantages: the simple and hygienically unproblematic use and the absence of any artefacts by the perfusion medium compared with water-perfusion, and the considerably lower costs compared with the solid-state catheters. Every method has own normal values because of the specific pressure transmission and the design of the catheter probes. To our knowledge, normal values for gas-perfusion manometry of the esophagus have not yet been published.The esophageal manometry with helium-perfused catheters was performed in 30 healthy volunteers. The main parameters of the esophageal motility and the lower esophageal sphincter were analyzed by liquid and bolus-like swallows and compared with the previous published values in other manometric procedures.The values of the motility in the distal esophagus are consistent; the pressure of the lower esophageal sphincter is generally lower than with other methods. The distal wave amplitude and the propagation velocity are significant higher in the distal esophagus than in the middle. The perfusion medium is well tolerated by the investigated volunteers.
[Mh] MeSH terms primary: Esophagus/physiology
Manometry/methods
[Mh] MeSH terms secundary: Adult
Catheterization/methods
Esophageal Sphincter, Lower/physiology
Female
Helium
Humans
Male
Patient Satisfaction
Perfusion
Pressure
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:206GF3GB41 (Helium)
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009910

  6 / 3147 MEDLINE  
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[PMID]: 29178261
[Au] Autor:Rosen R; Garza JM; Tipnis N; Nurko S
[Ad] Address:Aerodigestive Center, Boston Children's Hospital, Boston, MA, USA.
[Ti] Title:An ANMS-NASPGHAN consensus document on esophageal and antroduodenal manometry in children.
[So] Source:Neurogastroenterol Motil;30(3), 2018 Mar.
[Is] ISSN:1365-2982
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Upper gastrointestinal symptoms in children are common and motility disorders are considered in the differential diagnosis. High resolution esophageal manometry (HRM) has revolutionized the study of esophageal physiology, and the addition of impedance has provided new insights into esophageal function. Antroduodenal motility has provided insight into gastric and small bowel function. PURPOSE: This review highlights some of the recent advances in pediatric esophageal and antroduodenal motility testing including indications, preparation, performance, and interpretation of the tests. This update is the second part of a two part series on manometry studies in children (first part was on anorectal and colonic manometry [Neurogastroenterol Motil. 2016;29:e12944]), and has been endorsed by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the American Neurogastroenterology and Motility Society (ANMS).
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1711
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:In-Data-Review
[do] DOI:10.1111/nmo.13239

  7 / 3147 MEDLINE  
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[PMID]: 29454796
[Au] Autor:Khashab MA; Benias PC; Swanstrom LL
[Ad] Address:Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA. Electronic address: mkhasha1@jhmi.edu.
[Ti] Title:Endoscopic Myotomy for Foregut Motility Disorders.
[So] Source:Gastroenterology;, 2018 Feb 15.
[Is] ISSN:1528-0012
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure classically performed for the treatment of achalasia. The procedure is based on principles of submucosal endoscopy and is comprised of a mucosal incision, submucosal tunneling, myotomy and mucosal closure. Multiple published studies that collectively include more than 6000 patients reported clinical success in more than 80-90% of patients. Recent literature also suggested durability of response over a medium-term follow-up. POEM is associated with a low rate of adverse events when performed by experienced operators. Gastroesophageal reflux is not infrequent after POEM but does not seem significantly different from reflux which occurs after Heller myotomy. POEM also seems to be effective in the treatment of spastic esophageal disorders (e.g. Jackhammer and diffuse esophageal spasm). Lastly, the role of gastric POEM (G-POEM) in the treatment of gastroparesis has been investigated in recent studies with promising results.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180218
[Lr] Last revision date:180218
[St] Status:Publisher

  8 / 3147 MEDLINE  
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[PMID]: 29444329
[Au] Autor:Posner S; Zheng J; Wood RK; Shimpi RA; Hartwig MG; Chow SC; Leiman DA
[Ad] Address:Department of Medicine.
[Ti] Title:Gastroesophageal reflux symptoms are not sufficient to guide esophageal function testing in lung transplant candidates.
[So] Source:Dis Esophagus;, 2018 Feb 09.
[Is] ISSN:1442-2050
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Gastroesophageal reflux disease and esophageal dysmotility are prevalent in patients with advanced lung disease and are associated with graft dysfunction following lung transplantation. As a result, many transplant centers perform esophageal function testing as part of the wait-listing process but guidelines for testing in this population are lacking. The aim of this study is to describe whether symptoms of gastroesophageal reflux correlate with abnormal results on pH-metry and high-resolution manometry and can be used to identify those who require testing. We performed a retrospective cohort study of 226 lung transplant candidates referred for high-resolution manometry and pH-metry over a 12-month period in 2015. Demographic data, results of a standard symptom questionnaire and details of esophageal function testing were obtained. Associations between the presence of symptoms and test results were analyzed using Fisher's exact tests and multivariable logistic regression. The most common lung disease diagnosis was interstitial lung disease (N = 131, 58%). Abnormal pH-metry was seen in 116 (51%) patients and the presence of symptoms was significantly associated with an abnormal study (p < 0.01). Dysmotility was found in 98 (43%) patients, with major peristaltic or esophageal outflow disorders in 45 (20%) patients. Symptoms were not correlated with findings on esophageal high-resolution manometry. Fifteen of 25 (60%) asymptomatic patients had an abnormal manometry or pH-metry. These results demonstrate that in patients with advanced lung disease, symptoms of gastroesophageal reflux increase the likelihood of elevated acid exposure on pH-metry but were not associated with dysmotility. Given the proportion of asymptomatic patients with abnormal studies and associated post-transplant risks, a practice of universal high-resolution manometry and pH-metry testing in this population is justifiable.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[St] Status:Publisher
[do] DOI:10.1093/dote/dox157

  9 / 3147 MEDLINE  
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[PMID]: 29444254
[Au] Autor:Vazquez-Elizondo G; Hernández-González LE; Achem SR
[Ad] Address:Escuela Nacional de Medicina, Tecnológico de Monterrey, Monterrey, Nuevo León, Mexico.
[Ti] Title:High-resolution esophageal manometry in a Mexican population: diagnostic outcome.
[So] Source:Dis Esophagus;, 2018 Feb 09.
[Is] ISSN:1442-2050
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:High-resolution esophageal manometry (HREM) has become the method of choice for evaluation of esophageal motility disorders. There is a paucity of data with this technique from Hispanic countries. This study aims to characterize the diagnostic outcome of HREM in a large cohort of consecutive patients in Mexico.This study was conducted in Monterrey, Mexico from March 1, 2013 to March 31, 2015. Our diverse study population included patients from a major academic institution and the community. HREM was done applying the Chicago Classification 3. Diagnostic outcome was grouped as weak peristaltic disorders, gastroesophageal junction disorders, and hypertensive/uncoordinated peristalsis.We studied 670 consecutive patients, 57% were women, mean age was 43.8 years. The majority (465 [69%]) were referred for preoperative evaluation of gastroesophageal reflux disease (GERD), 365 (78%) of whom had a normal study. Overall, 193 (29%) patients had abnormal motility, the most common disorder being weak peristalsis (104 [54%]). In patients with dysphagia, the most frequent finding was achalasia (23/46 [50%]).To our knowledge, this is the first study to characterize the diagnostic outcome of HREM in a large cohort of Hispanic patients in Latin America. At our open access center, 69% of patients were referred for preoperative evaluation of GERD, reflecting the popularity of antireflux surgery. This study confirms the high prevalence of weak peristalsis and highlights the importance of addressing its pathophysiology and management. The finding of achalasia in 50% of our patients with dysphagia is consistent with recent reports regarding the rising incidence of this disorder and underscores the need of prompt motility testing in this population.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[St] Status:Publisher
[do] DOI:10.1093/dote/dox159

  10 / 3147 MEDLINE  
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[PMID]: 29441683
[Au] Autor:Giudicessi JR; Ackerman MJ; Camilleri M
[Ad] Address:Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
[Ti] Title:Cardiovascular safety of prokinetic agents: A focus on drug-induced arrhythmias.
[So] Source:Neurogastroenterol Motil;, 2018 Feb 14.
[Is] ISSN:1365-2982
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Gastrointestinal sensorimotor dysfunction underlies a wide range of esophageal, gastric, and intestinal motility and functional disorders that collectively constitute nearly half of all referrals to gastroenterologists. As a result, substantial effort has been dedicated toward the development of prokinetic agents intended to augment or restore normal gastrointestinal motility. However, the use of several clinically efficacious gastroprokinetic agents, such as cisapride, domperidone, erythromycin, and tegaserod, is associated with unfavorable cardiovascular safety profiles, leading to restrictions in their use. PURPOSE: The purpose of this review is to detail the cellular and molecular mechanisms that lead commonly to drug-induced cardiac arrhythmias, specifically drug-induced long QT syndrome, torsades de pointes, and ventricular fibrillation, to examine the cardiovascular safety profiles of several classes of prokinetic agents currently in clinical use, and to explore potential strategies by which the risk of drug-induced cardiac arrhythmia associated with prokinetic agents and other QT interval prolonging medications can be mitigated successfully.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[St] Status:Publisher
[do] DOI:10.1111/nmo.13302


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