OBJECTIVE To review the current management of achalasia, and the controversies regarding the different treatment options. METHODS A review of the literature was performed. The key words used were esophageal achalasia, Heller myotomy, endoscopic balloon dilatation, laparoscopic Heller myotomy, and fundoplication. RESULTS Patients who fail medical therapy (e.g. pharmacologic therapy, botulinu...

AIM To compare long-term occurrence of gastroesophageal reflux disease (GERD) between two different types of peroral endoscopic myotomy (POEM) for achalasia. METHODS We included all patients with achalasia who underwent POEM at our hospital from August 2011 to October 2012 and had complete GERD evaluation with ≥ 3 years of follow-up. They were divided into circular or full-thickness myotomy g...

Abstract Achalasia is a primary defect of esophageal motility unknown aetiology, characterised by peristaltic dysfunction the esophagus and impaired relaxation lower sphincter. The most common symptoms are dysphagia, regurgitation, weight loss, chest burning. There various treatment options for achalasia: botulinum toxin injections, pneumatic dilatation, Heller myotomy, peroral endoscopic myoto...

BACKGROUND The optimal therapeutic schedule in patients with achalasia is still under discussion. The aim of this study was to review our institution's experience with myotomy and dilation in patients with achalasia. MATERIAL AND METHODS Clinical data were available for 59 patients who had ever had myotomy (n=38), dilation (n=21), or both procedures (n=8) between 2000 and 2007. Patients were ...

HYPOTHESIS There is general agreement that a Heller myotomy should extend 6 to 7 cm above the gastroesophageal junction. Results of most previous studies have recommended that the myotomy extend 1 to 1.5 cm below the gastroesophageal junction. We speculated that the effectiveness of the operation could be improved if a longer, 3-cm myotomy was carried out below the gastroesophageal junction, as...

PURPOSE Z-myotomy is an extraocular muscle (EOM) weakening procedure in which two incisions are made from longitudinally-separated, opposite EOM margins for treatment of strabismus. We examined the in vitro biomechanics of Z-myotomy using tensile loading. METHODS Fresh bovine rectus EOMs were reduced to 20 × 10 × 2-mm dimensions, and clamped in a microtensile load cell under physiological con...

HYPOTHESIS Operative manometry detects residual esophagogastric junction (EGJ) high pressure, ensuring complete myotomy. DESIGN Consecutive patients undergoing laparoscopic myotomy. SETTING Tertiary care academic medical center. PATIENTS From 1997 to 2003, 139 patients with achalasia underwent laparoscopic myotomy. INTERVENTIONS We assessed myotomy completeness by operative endoscopy an...

OBJECTIVE To compare swallowing outcomes following cricopharyngeal (CP) dilation versus surgical myotomy in patients with dysphagia secondary to idiopathic CP bar. METHODS All patients had an idiopathic CP bar without a history of Zenker's diverticulum, head and neck cancer, or systemic neurologic disease treated between 2000 and 2013. The Functional Outcome Swallowing Scale (FOSS) was utiliz...

More and more endoscopically gastrointestinal procedures require anesthesiologists to perform general anesthesia, such as "peroral endoscopic myotomy". Peroral endoscopic myotomy is a novel invasive treatment for the primary motility disorder of esophagus, called esophageal achalasia. Despite of its minimally invasive feature, there are still complications during the procedure which develop to ...

Background. Here we aimed to evaluate and compare the efficacy and safety between partial full-thickness myotomy and circular muscle myotomy during POEM procedure in achalasia patients. Methods. Clinical data of achalasia of cardia (AC) patients who underwent POEM in our center during January 2014 to January 2015 was collected (34 cases). 19 patients who received partial full-thickness myotomy ...