BACKGROUND In the treatment of achalasia, surgery has been traditionally reserved for patients with residual dysphagia after pneumatic dilatation. The results of laparoscopic Heller myotomy have proven to be so good, however, that most experts now consider surgery the primary treatment. HYPOTHESIS The outcome of laparoscopic myotomy and fundoplication for achalasia is dictated by technical fa...

Achalasia is an esophageal motility disorder that leads to dysphagia, chest pain, and weight loss. Its diagnosis is clinically suspected and is confirmed with esophageal manometry. Although pneumatic dilation has a role in the treatment of patients with achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed acha...

OBJECTIVES In the early 1990s, minimally invasive videoscopy was applied to numerous operations. After undertaking more than 50 "open" Heller myotomies, our experience with videoscopic Heller myotomy began in 1992. We sought to determine whether the outcome following videoscopic Heller myotomy is influenced by surgeon experience. METHODS Seventy-eight patients with severe dysphagia secondary ...

BACKGROUND/AIMS The role of the enteric (ENS) and central (CNS) nervous systems in the control of the retrograde giant contraction (RGC) associated with vomiting is unknown. METHODS The effects of myotomy or mesenteric nerve transection (MNT) on apomorphine-induced emesis were investigated in 18 chronically instrumented dogs. RESULTS Neither surgery affected the RGC orad of the surgical sit...

INTRODUCTION Two types of partial wrap are commonly performed in achalasia patients after Heller myotomy: the posterior 270° fundoplication (Toupet) and the anterior 180° fundoplication (Dor). The optimal type of fundoplication (posterior vs. anterior) is still debated. AIM To compare the long-term rates of dysphagia, reflux symptoms and patient satisfaction with current postoperative conditi...

We first want to express appreciation for publishing “Hyoid Surgery Alone for Obstructive Sleep Apnea: A Systematic Review and Meta-analysis” in a recent issue of The Laryngoscope. We recognize the need for an improved understanding of the isolated hyoid procedures for patients suffering from obstructive sleep apnea (OSA). However, our own experience regarding hyoid myotomy with mandibular susp...

esophageal spasm Diffuse esophageal spasm (DES) is a rare esophageal dysmotility condition characterized by simultaneous contractions of the distal esophagus and manifested by dysphagia and chest pain. Pharmacological therapy, endoscopic interventions, and surgical myotomy have been linked to various outcomes [1,2]. Recently, peroral endoscopic myotomy (POEM) has been introduced as an effective...

Achalasia is the most common primary motility disorder of the esophagus and presents as dysphagia to solids and liquids. It is characterized by impaired deglutitive relaxation of the lower esophageal sphincter. High-resolution manometry allows for definitive diagnosis and classification of achalasia, with type II being the most responsive to therapy. Since no cure for achalasia exists, early di...

BACKGROUND An increasing number of elderly patients diagnosed with achalasia are being referred for minimally invasive myotomy. Little data are available about the operative outcomes in this population. The objective of this study was to review our experience with this procedure in an elderly population. METHODS A retrospective review was performed of 51 consecutive patients, 65 years of age ...

Background and study aims  Peroral endoscopic myotomy (POEM) can be performed via an anterior or posterior approach, depending on the operator's preference. Data are lacking on comparative outcomes of both approaches. Patients and methods  This is a pilot randomized study comparing endoscopic anterior and posterior myotomy during POEM in patients with Achalasia cardia (AC). Patients were rand...