Endoscopic Therapy for Achalasia Before Heller Myotomy Results in Worse Outcomes Than Heller Myotomy Alone

Smith, C. Daniel; Stival, Alessandro R.; Howell, Della L.; Swafford, Vickie

doi:10.1097/01.sla.0000217524.75529.2d

Cited by 219 publications

(123 citation statements)

References 16 publications

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“…The EUS-guided BTI has a low initial success rate and the high rate of achalasia recurrence cannot be ignored. Additionally, repeated treatments with BTI have been shown to make subsequent Heller myotomy more challenging [9]. Although PD after TIPS carries a low risk of hemorrhage, patients need to be monitored for hepatic encephalopathy after TIPS and surgical intervention is required if the patient suffers from esophageal perforation requiring repair [8].…”

Section: Discussionmentioning

confidence: 99%

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

Shen

Wang

Zhang

et al. 2019

JGLD

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Achalasia is very uncommon, and rarely does achalasia co-exist with esophageal varices. We present a 62-year-old woman who was diagnosed with both achalasia and esophageal varices in December 2014 and had a past history of hematemesis. The patient’s achalasia symptoms’ Eckardt score was 9, and her hepatic function was Child-Pugh grade A6. After comprehensive assessment of the patient’s health and discussion of the pros and cons of various therapies for achalasia, the patient underwent a peroral endoscopic myotomy. She was symptom-free after the operation and had no recurrence of achalasia symptoms at 20-month follow-up. No adverse events were reported. Peroral endoscopic myotomy for achalasia with esophageal varices has not been previously reported in the English literature.Abbreviations: BTI: Botulinum toxin injections; EUS: Endoscopic ultrasonography; GEJ: Gastroesophageal junction; HIFU: High-intensity focused ultrasound; LHM: Laparoscopic Heller myotomy; PD: Pneumatic dilation; POEM: Peroral endoscopic myotomy; TIPS: Transjugular intrahepatic portosystemic shunt.

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Section: Discussionmentioning

confidence: 99%

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

Shen

Wang

Zhang

et al. 2019

JGLD

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“…Few patients required reoperation in the available series; the great majority was treated by PCD or the botulinum toxin 21,22,[27][28][29][30][32][33][34] .…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Qualidade de vida após a cardiomiotomia à Heller-Dor

Madureira¹,

Madureira²,

Loss³

et al. 2009

Rev. Col. Bras. Cir.

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, were studied retrospectively. Before surgery, the demographics and the diagnostic test results were recorded. The patients submitted a dysphagia score for quality of life before and after surgery, and lower esophageal sphincter pressure (PLES) was measured. We also studied the difference produced in quality of life Results:Results: Results: Results: Results: 37 women and 23 men were followed. Mean age was 41.08 (12-87). There was no mortality and no conversions. The mean time of diet resumption was 1.6 day. The outcome was considered excellent in 80% of the series and intermediate in 20% of the series. The mean dysphagia score before surgery was 9.03 points, and after surgery, 1.7 point (maximum of 10 points), p=0.0001. The mean score decrease between pre-and postoperative scores was 7.33 points (87.17%). The mean PLES before surgery was 32.41 mmHg, and 12.7 mmHg after. Conclusion:Conclusion: Conclusion: Conclusion: Conclusion: HDL is a safe procedure and changed significantly the subjective quality of life scores, as well as the objective PLES means.

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“…Pneumatic dilatation causes some scarring which may increase the difficulty of Heller myotomy if the surgery is needed later. 15 There have been reports of GERD after pneumatic dilatation in some patients.…”

Section: Pneumatic Dilatationmentioning

confidence: 99%

“…Botox injections cause scarring in the sphincter which may increase the difficulty of later Heller myotomy. 15 This therapy is only recommended for patients who cannot risk surgery, such as elderly persons in poor health.…”

Section: Medicationsmentioning

confidence: 99%

Achalasia Cardia: Revisited

Premkumar¹,

Paul²

2017

WJOLS

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Introduction: Achalasia cardia is a very common esophageal motility disorder affecting a large population worldwide including the Indian subcontinent. The diagnosis of the condition is equally important as the treatment ranges from medicines to botulinum injection, to pneumatic dilatation and surgery. This study gives an overview of achalasia cardia and the modalities to diagnose and treat the condition.

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Endoscopic Therapy for Achalasia Before Heller Myotomy Results in Worse Outcomes Than Heller Myotomy Alone

Cited by 219 publications

References 16 publications

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

Qualidade de vida após a cardiomiotomia à Heller-Dor

Achalasia Cardia: Revisited

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