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Chirurg 2019 Feb 13. Epub 2019 Feb 13.

Klinik für Allgemein‑, Viszeral- und Tumorchirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

World J Surg 2019 Feb 12. Epub 2019 Feb 12.

Mayne Medical School, School of Medicine, University of Queensland, Brisbane, QLD, Australia.

Background And Aims: Partial fundoplication is commonly performed in conjunction with Heller Myotomy. It is, however, controversial whether anterior Dor or posterior Toupet partial fundoplication is the antireflux procedure of choice. The aim was to perform a systematic review and meta-analysis of studies comparing these two procedures. Read More

Z Gastroenterol 2019 Feb 12;57(2):151-155. Epub 2019 Feb 12.

Medizinische Klinik II, HELIOS Klinikum Krefeld, Germany.

Background:  Eosinophilic esophagitis (EoE) is detected frequently in dysphagia and noncardiac chest pain. Management of patients with EoE may be complicated because EoE is associated frequently with esophageal motility disorders. We present the rare case of esophageal achalasia (EA) associated with eosinophilic infiltration and a literature review. Read More

Am Surg 2018 Nov;84(11):1796-1800

Pneumatic balloon dilatation (BD) and laparoscopic Heller's myotomy (LHM) are usually preferred treatment options for relieving dysphagia symptoms in achalasia. The aim of the present study was to describe a new technical method for a safe and effective LHM. Endoscopic BD tube (Rigiflex 30-mm pneumatic balloon) is simultaneously insufflated and desufflated in the esophagus during LHM to assess myotomy in 50 consecutive patients. Read More

An Pediatr (Barc) 2019 Feb 7. Epub 2019 Feb 7.

Unidad Pediátrica, Servicio de Otorrinolaringología, Complejo Hospitalario Universitario A Coruña, A Coruña, España.

BMC Gastroenterol 2019 Feb 11;19(1):28. Epub 2019 Feb 11.

University of South Florida, Division of Gastroenterology, Florida, USA.

An elevation of serum inflammatory biomarkers in achalasia patients compared with controls recently was demonstrated. It has not been determined whether the elevation of inflammatory cytokines is unique to achalasia or occurs with other diseases involving the esophagus. The primary aim of our study was to compare the differences in plasma immunological profiles (TNF- α receptor, IL-6, IFN-γ, IL-12, IL-17, IL-22, and IL-23) of patients with achalasia, eosinophilic esophagitis (EoE), and gastroesophageal reflux disease (GERD). Read More

Am J Gastroenterol 2019 Feb 5. Epub 2019 Feb 5.

Division of Gastroenterology and Hepatology, Northwestern Medicine, Chicago, Illinois, USA.

Introduction: To compare the utility of the distensibility index (DI) on functional lumen imaging probe (FLIP) topography to other esophagogastric junction (EGJ) metrics in assessing treatment response in achalasia in the context of esophageal anatomy.

Methods: We prospectively evaluated 79 patients (at ages 17-81 years; 47% female patients) with achalasia during follow-up after pneumatic dilation, Heller myotomy, or per-oral endoscopic myotomy with timed barium esophagram, high-resolution impedance manometry, and FLIP. Anatomic deformities were identified based on consensus expert opinion. Read More

Case Rep Gastrointest Med 2019 13;2019:1803036. Epub 2019 Jan 13.

Division of Gastroenterology and Hepatology, SBH Health System, 4422 Third Ave, Bronx, New York 10457, USA.

Achalasia is an intrinsic disorder of the esophagus that results from loss of ganglion cells in the lower esophageal sphincter. Clinically it is manifested by dysphagia to solids and liquids, weight loss, regurgitation, and chest pain. Pseudoachalasia, in contrast, is a rare entity that causes identical symptoms, but has a divergent underlying pathogenesis. Read More

Int J Surg Case Rep 2019 Jan 31;55:129-131. Epub 2019 Jan 31.

Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States. Electronic address:

Introduction: Gastro-jejunostomy tube is used for post-pyloric feeding for critical-ill patient who cannot tolerate oral alimentation. Jejuno-jejunal intussusception is a rare complication of gastrojejunostomy tube.

Presentation Of Case: A 39-year-old male with history of severe combined immunodeficiency, Achalasia and end-stage lung disease underwent double lung transplantation. Read More

Dig Surg 2019 Feb 5:1-9. Epub 2019 Feb 5.

Division of General Surgery, Morsani College of Medicine, University of South Florida, Tampa, Florida,

Purpose: The purpose of this study was to compare demographics, symptoms, prior interventions, operation, and outcomes of patients who underwent Heller myotomy for esophageal motility disorders and epiphrenic diverticulectomy with Heller myotomy.

Methods: We identified all patients who underwent Heller myotomy for esophageal motility disorders with and without esophageal diverticulectomy over an 80-month period. Primary data points included patient demographics, presenting symptoms, prior intervention, high-resolution manometry, surgery performed with rate of laparoscopic, conversion to open, and open procedures; postoperative complications, and symptom resolution. Read More

Rambam Maimonides Med J 2019 Jan 28;10(1). Epub 2019 Jan 28.

GI Physiology Unit, University College London Hospital, London, United Kingdom.

Achalasia is a chronic idiopathic disease characterized by the absence of esophageal body peristalsis and by defective lower esophageal sphincter (LES) relaxation. The incidence rate ranges from 1.07 to up to 2. Read More

Ther Adv Chronic Dis 2018 11;9(12):257-267. Epub 2018 Sep 11.

GI Services, University College London Hospital, Ground floor west, 250 Euston Road, London, NW1 2 PG, London, UK.

Oesophageal physiology testing plays an important role in the diagnosis of noncardiac chest pain (NCCP) after cardiac, structural and mucosal abnormalities have been ruled out. Endoscopy can establish the presence of structural causes of chest pain such as cancer, oesophageal webs and diverticula. Even if macroscopically normal, eosinophilic oesophagitis is a common cause of chest pain and needs to be ruled out with an adequate biopsy regimen. Read More

Clin Gastroenterol Hepatol 2019 Jan 29. Epub 2019 Jan 29.

Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background & Aims: Under the Chicago Classification of esophageal motility disorders, esophagogastric junction outflow obstruction (EGJOO) includes a varied clinical spectrum that results in diagnostic and management difficulties. We aimed to demonstrate that including upright swallows during high-resolution manometry (HRM) helps identify patients with clinically significant EGJOO.

Methods: We performed a retrospective study of consecutive patients diagnosed with EGJOO on HRM from January 2015 through July 2017. Read More

J Clin Gastroenterol 2019 Jan 29. Epub 2019 Jan 29.

Gastrointestinal Endoscopy Unit, University of Sao Paulo Medical School, Sao Paulo, Brazil.

Background: Per-oral endoscopic myotomy (POEM) has become the preferred alternative treatment to standard Heller myotomy for patients with esophageal achalasia, in Latin American countries. The aim of our study was to evaluate the efficacy and safety of a POEM in the management of achalasia with and without Chagas disease in patients receiving POEM.

Methods: Patients who underwent POEM from tertiary centers in Latin America were included in a dedicated registry. Read More

Ter Arkh 2018 May;90(5):93-100

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.

Aim: To present application of Chicago classification criteria of esophageal motility disorders defined in high resolution manometry in clinical practice.

Materials And Methods: High-resolution manometry is the most exact hi-tech diagnostic method for esophageal motor function disorders according to Chicago classification v3.0. Read More

World J Gastroenterol 2019 Jan;25(4):411-417

Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA 30322, United States.

Esophagogastric junction outflow obstruction (EGJOO) is a major motility disorder based on the Chicago Classification of esophageal motility disorders. This entity involves a heterogenous group of underlying etiologies. The diagnosis is reached by performing high-resolution manometry. Read More

Neurogastroenterol Motil 2019 Jan 30:e13548. Epub 2019 Jan 30.

Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.

Background And Aims: One of the most used treatments for achalasia is pneumatic dilation of the lower esophageal sphincter to improve esophageal emptying. Multiple treatment protocols have been described with a varying balloon size, number of dilations, inflation pressure, and duration. We aimed to identify the most efficient and safe treatment protocol. Read More

J Gastroenterol Hepatol 2019 Jan 29. Epub 2019 Jan 29.

Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea.

Background/aims: Optimal treatment modalities for each of the three subtypes of achalasia is still under debate. Differences in prognosis and long-term outcomes between peroral endoscopic myotomy (POEM) and balloon dilation (BD) are also unclear. We aimed to compare the treatment outcomes of BD and POEM in each subtypes of achalasia by using information from the manometry database of a tertiary referral center in Korea. Read More

Br J Surg 2019 Jan 28. Epub 2019 Jan 28.

Department of Surgery, Brigham and Women's Hospital and Boston VA Healthcare System, Harvard Medical School, Boston, Massachusetts, USA.

Background: The introduction of high-resolution manometry and the Chicago classification has made it possible to diagnose achalasia and predict treatment response accurately. The aim of this study was to compare the effect of the different treatments available on symptomatic outcomes across all achalasia subtypes.

Methods: The study was conducted according to PRISMA and MOOSE guidelines. Read More

Curr Treat Options Gastroenterol 2019 Jan 26. Epub 2019 Jan 26.

Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.

Purpose Of The Review: The novel concept of third space endoscopy was first applied to humans in 2008 for the management of achalasia through peroral endoscopic myotomy (POEM) procedure. Over the ensuing 10 years, this revolutionary procedure, which started in Japan, has been adopted and mastered by surgeons and gastroenterologists across the globe. In this article, we review the recent innovations and applications of third space endoscopy in the management of esophageal disorders. Read More

GE Port J Gastroenterol 2018 Dec 13;26(1):75-77. Epub 2018 Mar 13.

Gastroenterology Department, Amato Lusitano Hospital, Castelo Branco, Portugal.

Surg Endosc 2019 Jan 22. Epub 2019 Jan 22.

Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.

Background And Aims: Achalasia cardia is rare in children and optimum endoscopic management options are not well known. Peroral endoscopic myotomy (POEM) is a novel treatment modality for achalasia with excellent results in adult patients. The long-term outcomes of POEM are not well known in children. Read More

Gastrointest Endosc 2019 02;89(2):274-276

Predictive Health, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA.

Gut Liver 2019 01;13(1):3-4

Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

Tohoku J Exp Med 2019 ;247(1):41-49

Division of Gastroenterology and Hepatobiliary Pancreatic Surgery, Tohoku Medical and Pharmaceutical University.

Esophageal achalasia is a disease characterized by the impaired esophageal peristalsis and non-relaxation of the lower esophageal sphincter muscle with unknown causes. Clinical manifestation of the disease is nonspecific (e.g. Read More

Endoscopy 2019 Feb 17;51(2):161-164. Epub 2019 Jan 17.

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan.

Background:  Peroral endoscopic myotomy (POEM) has become the minimally invasive endoscopic treatment for achalasia; however, gastroesophageal reflux (GER) post-POEM has been reported. A pilot study was conducted in which an endoscopic fundoplication was added to the standard POEM (POEM + F) procedure to overcome this issue. We report the technical details of POEM + F and short-term safety results. Read More

Scand J Gastroenterol 2019 Jan 16:1-7. Epub 2019 Jan 16.

a Department of Gastroenterology , Oslo University Hospital.

Objectives: Achalasia is a primary motility disorder of the esophagus characterized by aperistalsis and failure of lower esophageal sphincter (LES) relaxation. Treatment of achalasia aims at reducing LES pressure. The common treatment modalities are laparoscopic Heller myotomy and pneumatic dilatation, but during the last decade, a promising treatment, per oral endoscopic myotomy (POEM), has been introduced. Read More

J Neurogastroenterol Motil 2019 Jan;25(1):75-81

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background/aims: Esophagogastric junction outflow obstruction (EGJOO) is a diagnostically heterogeneous group with variable clinical relevance. We studied whether evaluation of bolus transit by multichannel intraluminal impedance (MII) is useful for discriminating clinically relevant EGJOO.

Methods: A total 169 patients diagnosed as having EGJOO between June 2011 and February 2018 were analyzed. Read More

Acta Gastroenterol Belg 2018 Oct-Dec;81(4):543-544

Gastroenterology Division, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Acta Gastroenterol Belg 2018 Oct-Dec;81(4):531-533

ZNA Middelheim, Department of Gastro-enterology.

We present a case of a 28-year old woman who presented with bizarre wheezing breath sounds on expiration and dysphagia, with unexplained significant dilation of the esophagus mimicking achalasia finally leading to the diagnosis of a very small congenital tracheoesophageal fistula (TEF). Congenital TEF is usually detected shortly after birth and is typically accompanied by esophageal atresia. Congenital TEF without esophageal atresia (H-type fistula) can be missed in early life and diagnosis may be postponed until adulthood due to subtle symptoms. Read More

World J Gastroenterol 2019 Jan;25(1):1-41

H.H. Chao Comprehensive Digestive Disease Center, University of California, Irvine Medical Center, Orange, CA 92868, United States.

In this paper, I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgically. Within each topic, the content will progress as follows: "lessons learned", "technical considerations" and "future opportunities". Lessons learned will provide a brief background and update on the most current literature. Read More

BMJ Case Rep 2019 Jan 14;12(1). Epub 2019 Jan 14.

Department of Neurology, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK.

Neuromyelitis optica spectrum disorder (NMOSD) is a rare neurological condition infrequently associated with dysphagia on initial presentation. We describe the case of a 54-year-old woman who presented multiple times to healthcare professionals with severe vomiting, followed by sudden profound dysphagia. Her diagnosis was elusive, initially attributed to achalasia cardia and subsequently to stroke. Read More

J Formos Med Assoc 2019 Jan 8. Epub 2019 Jan 8.

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address:

Background: Esophageal motility disorders are the major cause of non-obstructive dysphagia (NOD), but may be underdiagnosed. In this high-resolution impedance manometry (HRIM)-based study, we aimed to clarify the etiologies and clinical characteristics of patients presenting with NOD in a Taiwanese population.

Methods: From October 2014 to July 2017, consecutive patients with the chief complaint of dysphagia were prospectively enrolled in the study at a tertiary medical center. Read More

Endoscopy 2019 Jan 10. Epub 2019 Jan 10.

Division of Gastroenterology and Hepatology, National Medical Center Century XXI, Mexico City, Mexico.

Background:  Peroral endoscopic myotomy (POEM) is a recognized technique for patients with achalasia. We aimed to evaluate the feasibility of using a small-caliber endoscope (thin-POEM) to perform POEM in patients with achalasia.

Methods:  Naïve or previously treated patients were included between February 2016 and April 2018. Read More

Rev Med Suisse 2019 Jan;15(N° 632-633):31-33

Service de chirurgie viscérale, CHUV, 1011 Lausanne.

Surgical management of oncologic situations in visceral surgery is increasing. Overall survival and related quality of life are improved, due to enhanced perioperative care, improvement in strategies like surgical technique and oncological therapy. Functional disorders, whether or not related to oncologic disease, are not to be forgotten. Read More

VideoGIE 2019 Jan 13;4(1):14-16. Epub 2018 Nov 13.

Asian Institute of Gastroenterology, Hyderabad, India.

Infect Agent Cancer 2018 29;13:43. Epub 2018 Dec 29.

1Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Villela, 1331, Barretos, SP CEP 14784 400 Brazil.

Background: Chronic diseases such as chagasic megaesophagus (secondary to Chagas' disease) have been suggested as etiological factors for esophageal squamous cell carcinoma; however, the molecular mechanisms involved are poorly understood.

Objective: We analyzed hotspot gene mutations in a series of esophageal squamous cell carcinomas associated or not with chagasic megaesophagus, as well as, in chagasic megaesophagus biopsies. We also checked for correlations between the presence of mutations with patients' clinical and pathological features. Read More

Hormones (Athens) 2019 Jan 5. Epub 2019 Jan 5.

Eunice Kennedy Shriver National Institute of Child Health and Human Development, 10 Center Drive, Building 10, Room 1-3330, Bethesda, MD, 20892, USA.

Objective: Triple A syndrome is a rare autosomal recessive disorder caused by mutations in the AAAS gene on chromosome 12q13. Its main clinical features are alacrima, achalasia, and adrenal insufficiency, with most patients also having neurological symptoms and autonomic dysfunction. The neurologic manifestations are less well-understood, especially in children. Read More

J Gastroenterol 2019 Jan 3. Epub 2019 Jan 3.

Division of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, 757-1, Asahimachidori, Chuo-ku, Niigata, Niigata, 951-8510, Japan.

Background: Achalasia is a well-known esophageal motility disorder, but epidemiological studies in Japan are lacking. We investigated the incidence and period prevalence of achalasia in Japan, including the rate of coexistence of esophageal carcinoma, and evaluated treatment trends.

Methods: To estimate the nationwide number of patients with achalasia, a large-scale insurance claims database from 2005 to 2017 were used for our analyses. Read More

Gut 2019 Jan 3. Epub 2019 Jan 3.

Department of Gastroenterology, Sandwell and West Birmingham Hospitals, West Bromwich, UK.

Introduction: Achalasia is a disorder characterised by failed relaxation of the lower oesophageal sphincter. The aim of this study was to examine, at a national level, the long-term outcomes of achalasia therapies.

Methods: Hospital Episode Statistics include diagnostic and procedural data for all English National Health Service-funded hospital admissions. Read More

J Cardiothorac Surg 2019 Jan 3;14(1). Epub 2019 Jan 3.

Department of Gastroenterology, Affliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan Province, China.

Aim: In this retrospective review, we aimed to investigate the long-term efficacy and safety of POEM with follow-up period over 2 years.

Materials And Methods: A systematic review related to POEM for achalasia was conducted. A literature search was performed in Pubmed, Medline, Ovid, Cochrane and EBSCO databases on November 2017. Read More

Dig Dis 2019 Jan 2:1-8. Epub 2019 Jan 2.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz,

Pseudoachalasia is a condition in which symptoms, radiologic, endoscopic, and manometric findings mimick idiopathic achalasia. About 4% of patients with a typical constellation for idiopathic achalasia will turn out to have pseudoachalasia, posing a major diagnostic challenge. A large spectrum of underlying causes of pseudoachalasia has been described. Read More

Ann Gastroenterol 2019 Jan-Feb;32(1):46-51. Epub 2018 Nov 14.

Department of Surgery, 1 Propaedeutic Surgical Clinic, Hippocration General Hospital of Athens, University of Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Georgia Georgiou, Vasileios Kalles, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou).

Background: Current treatment options for achalasia of the esophagus predominantly consist of endoscopic myotomy or laparoscopic myotomy combined with a partial fundoplication. The intraoperative use of conventional manometry has previously been proposed with various results. The aim of the present study was to introduce the use of high-resolution manometry (HRM) during surgical treatment for achalasia and to assess the long-term outcome of this technique. Read More

Eur J Cardiothorac Surg 2018 Dec 27. Epub 2018 Dec 27.

Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey.

CASE (Phila) 2018 Dec 23;2(6):285-292. Epub 2018 Aug 23.

Department of Echocardiography, National Institute of Cardiology, Laranjeiras, Rio de Janeiro, Brazil.

Am J Med Sci 2018 Nov 10. Epub 2018 Nov 10.

Department of Internal Medicine and; Center for Neurogastroenterology and GI Motility, Texas Tech University Health Science Center - Paul L. Foster School of Medicine, El Paso, Texas. Electronic address:

Pseudocholinesterase deficiency is a rare genetic as well as an acquired disorder that affects the body's ability to metabolize choline esters such as succinylcholine and mivacurium. It can be inherited as an autosomal recessive trait, occurring in approximately 1 in 3,200 to 1 in 5,000 people. In most cases of pseudocholinesterase deficiency, no signs or symptoms of the condition exist. Read More

Eur J Cardiothorac Surg 2018 Dec 18. Epub 2018 Dec 18.

PhD Course in Cardio-Nephro-Thoracic Sciences, Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy.

Objectives: The risk factors for oesophageal achalasia, a precancerous condition that can lead to epidermoid carcinoma, are unknown. The aim of this study was to determine these factors.

Methods: Beginning in 1973, patients presenting with achalasia from 1955 to 2016 periodically underwent clinical assessment, the barium swallow test (the oesophageal diameter and residual barium column were measured) and endoscopy according to a prospective protocol. Read More

Int J Pediatr Otorhinolaryngol 2019 Jan 2;116:15-17. Epub 2018 Oct 2.

Nemours Children's Specialty Care, Division of Pediatric Otolaryngology, Jacksonville, FL, USA.

Cricopharyngeal achalasia is a rare cause of dysphagia in young children. Conservative treatments involve medical therapy and serial dilations or injections. Definitive cure can be achieved with cricopharyngeal myotomy. Read More

Surg Endosc 2018 Dec 14. Epub 2018 Dec 14.

Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.

Background: There is limited and conflicting data on the optimal intervention for the treatment of achalasia in adolescents and young adults (AYA), Heller myotomy (HM), esophageal dilation (ED) or botulinum toxin injection (botox). The goal of this study is to determine the most appropriate index intervention for achalasia in the AYA population.

Methods: We completed a longitudinal, population-based analysis of the California (2005-2010) and New York (1999-2014) statewide databases. Read More