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Long gap esophageal atresia: an Australian experience.

BACKGROUND: The diagnosis of long gap esophageal atresia (LGEA) may preclude immediate primary anastomosis. We reviewed our experience with this entity for a period of 10 years. METHODS: A retrospective review was undertaken of the medical records of all patients managed for esophageal atresia (EA)/tracheoesophageal fistula (TEF) during the period from 1991 to 2001 at the Children's Hospital at Westmead, Sydney, Australia. Esophageal atresia was defined as long gap when primary repair was considered technically impossible by the surgeon. Also, a questionnaire was sent to all the general pedia

[Hypertrophic obstructive cardiomyopathy: surgical treatment and results].

The natural history of hypertrophic obstructive cardiomyopathy is characterized, in particular, in younger patients by sudden cardiac death, … yopathy is provided by Table 1. From initial attempts to eliminate the outflow tract obstruction by myotomy, the subvalvular myectomy was developed in which an about 1 cm wide section of muscle is resected; this procedure can be carried out from a transaortic, transatrial or transventricular approach [4, 9, 21, 22, 24, 38, 39, 47]. Under the assumption th …

[Arrhythmias in hypertrophic cardiomyopathy. Significance and therapeutic consequences].

The natural history of the patient with hypertrophic cardiomyopathy is characterized by slow progression of symptoms and left ventricular hy … ause of sudden death have not been clearly elucidated. Although complete heart block may complicate myotomy or myectomy, the development, in an unoperated patient, of symptomatic conduction disease is uncommon. Preexcitation syndromes may be present in a small subpopulation (about 2%), but this appears seldom responsible for sudden death. Outflow tract sp …

Functional Popliteal Artery Entrapment Syndrome.

INTRODUCTION: Popliteal artery entrapment is an uncommon syndrome, caused by extrinsic compression of the popliteal artery by muscular or te … ignificant fibrosis. Since compression by the medial head of the gastrocnemius muscle was observed, myotomy of its lateral fibers was performed. The patient was discharged on the second day post-surgery. After three months, the patient remained free of symptoms, having taken up sports practice with no limitations. CONCLUSION: Continuous popliteal artery …

The use of the internet in data assimilation in rare diseases.

The incidence and prevalence of achalasia is 0.6/100,000 people per year and 1/10,000, respectively. It is difficult then for one center to … tempted on this population were balloon dilatation in 57%, botulinum toxin injection (Botox) in 8%, myotomy in 12%, by lifestyle/diet modification in 12%, and other treatments in 11%. We believe that the Internet can provide physician-researchers with useful information about common and uncommon diseases on a global basis. The Internet allows patients to …

Laparoscopic nipple invagination combined extravesical (NICE) reimplantation technique in the management of primary obstructed megaureter.

AIMS: Villanueva challenged Paquin's 5:1 tunnel length and showed in a computer simulation model that UVJ competence was more sensitive to a … were analysed. There were three modifications in this compared to Shanfield technique: 1. Detrusor myotomy was performed before opening the bladder mucosa. The detrusor edges were closed later over the invaginated ureter as an extravesical reimplantation. 2. The ureter was held invaginated inside the bladder mucosal opening by two sutures at 6 & 12 O' cl …

Treatment for swallowing difficulties (dysphagia) in chronic muscle disease.

BACKGROUND: The management of dysphagia (difficulty in swallowing), a common complication of long-term progressive muscle disease in childre … it was not possible to determine the benefit or otherwise of surgical intervention (cricopharyngeal myotomy or upper oesophageal dilatation) for oculopharyngeal muscular dystrophy or other chronic progressive muscle diseases, and dietary advice or enteral feeding for children with congenital myopathy, compared with no intervention or an alternative interv …

Personal experiences and algorithm of endoscopically assisted subperiosteal face lift in orientals for 5 years.

Orientals are anatomically distinct from Caucasians and are characterized by a thick dermis, a Mongoloid slant of the palpebral fissure, a relatively prominent zygoma and mandible angle, and a relatively flat nose. Given these characteristics, it was believed that the subperiosteal face lift was not suitable for Orientals. However, at our institution, endoscopically assisted subperiosteal face lifts were performed from May of 1994 to October of 1998 on 236 patients; variable pitfalls, as well as satisfying results, were reported. Patient ages ranged from 29 to 66 years (mean age, 55.2 years),

Selective peripheral denervation for refractory cervical dystonia: a single-center retrospective analysis of 160 cases.

OBJECTIVE: Cervical dystonia (CD) is the most common focal dystonia, characterized by abnormal head postures and pain, often refractory to botulinum toxin therapy. Selective peripheral denervation (SPD) remains a key surgical option, but long-term outcomes in large cohorts are underreported. The purpose of this study was to evaluate the long-term outcomes of SPD in patients with botulinum toxin-refractory CD, focusing on symptom severity, pain, and head posture improvement. METHODS: This retrospective study included 160 adults (mean ± SD age 54 ± 12.0 years, 46% male) with refractory CD who u

Management Strategies for Zenker's Diverticulum: A Comprehensive Review.

Zenker's diverticulum (ZD) is an esophageal condition that results in an outpouching of the mucosal layer through a weakened area in the hyp … ative, offering high success rates for patients with favorable anatomy. Zenker's peroral endoscopic myotomy (Z-POEM), adapted from treatments for achalasia, represents the latest advancement in ZD management. It involves creating a submucosal tunnel and precisely dividing the cricopharyngeus muscle. Z-POEM is minimally invasive and often provides quick re …

Clinical presentation and disease course of patients with esophagogastric junction outflow obstruction.

Esophagogastric junction outflow obstruction, characterized by preserved peristalsis in conjunction with an elevated integrated relaxation p … ents underwent treatment: medication (3), botulinum toxin injection followed by laparoscopic Heller myotomy (1), botulinum toxin injection and medication (1), and bougie dilation (1). Of the 18 patients with an unfavorable outcome, 6 patients underwent treatment: botulinum toxin injection (5) and medication (1). Computed tomography scan or endoscopic ultr …

Survival After Myectomy for Obstructive Hypertrophic Cardiomyopathy: What Causes Late Mortality?

BACKGROUND: Survival of patients with obstructive hypertrophic cardiomyopathy who undergo septal myectomy appears to be excellent and, in some series, is similar to that of matched populations. In this study, we investigated causes of late death in a large cohort of surgical patients. METHODS: Between January 1961 and October 2017, 2,956 patients underwent surgery for hypertrophic cardiomyopathy. We reviewed medical records of these patients. Vital status and causes of mortality were verified using 2 methods: LexisNexis Accurint, a commercially available resource, and the National Death Index

Laparoscopic Hiatal Hernia Repair: Short-Term Results From Yemen in a Resource-Limited Setting.

Background The laparoscopic minimally invasive surgery with anti-reflux procedure is the preferred method for hiatal hernia repair, showcasi … oscopic hiatal hernia repair combined with Nissen fundoplication, three (14.2%) patients had Heller myotomy with Dor fundoplication, and two (9.5%) patients underwent sleeve gastrectomy along with hiatal hernia repair. The average duration of the operation was 116 ± 60 minutes, while the average length of hospital stay was 3 ± 1.5 days. There was one (4.7 …

Upper esophageal sphincter abnormalities: frequent finding on high-resolution esophageal manometry and associated with poorer treatment response in achalasia.

BACKGROUND: Abnormalities of the upper esophageal sphincter (UES) on high-resolution esophageal manometry (HREM) have been observed in both … s. 100%, P=0.015). This remained true even after adjusting for type of treatment received (surgical myotomy, per-oral endoscopic mytotomy, botulinum toxin injection, pneumatic dilatation, medical therapy, P=0.67) and achalasia subtype (P=1.00). CONCLUSIONS: UES abnormalities are a frequent finding on HREM studies, especially in patients with impaired LES …

Symptoms and clinical outcomes of gastric electrical stimulation in treatment-resistant gastroparesis: a systematic review across short- and long-term follow-up.

BACKGROUND: Gastroparesis is a chronic disorder characterized by delayed gastric emptying without mechanical obstruction, significantly impa … direct comparisons of GES with pyloric-directed interventions - namely gastric per-oral endoscopic myotomy (G-POEM) and surgical pyloroplasty - to clarify the optimal positioning of GES within the contemporary treatment algorithm for refractory gastroparesis.

Gastroparesis: A Review.

IMPORTANCE: Gastroparesis is a condition of delayed gastric emptying in the absence of gastric outlet obstruction. Based on a 2018 US admini … evere gastroparesis. Severe refractory gastroparesis may be treated with gastric peroral endoscopic myotomy (G-POEM), which involves endoscopic-guided incision of the pylorus sphincter muscle, or gastric electrical simulation, in which an implanted neurostimulator sends electrical pulses to the stomach muscle. CONCLUSIONS AND RELEVANCE: Gastroparesis is …

Congenital esophageal stenosis associated with esophageal atresia: new concepts.

Congenital esophageal stenosis (CES) is suspected by a fixed intrinsic narrowing of the esophagus that affects the normal swallowing mechani … ent dilatations and is now doing well. A case of FMD did not improve after frequent dilatations and myotomy together with Nissen's fundoplication and required resection while the other case of FMD responded partially to dilatations. Cartilage in cases of CES requires surgical resection. Those with TBR without cartilage may not develop stricture. If strict …

Can't Stomach It: A Dilated Tale of Achalasia.

Achalasia is a common esophageal motility disorder defined by impaired relaxation of the gastroesophageal junction (GEJ). Complications can … astroenterology and possible general surgery for pneumatic dilation, botulinum toxin injection, and myotomy evaluation, respectively. Timely recognition and coordination between inpatient and outpatient care teams is imperative for optimizing outcomes.

Дисфагия в множестве склерозов: патофизиология, оценка и обзор управления.

Дисфагия является частым и угрожающим жизни осложнением множественного склероза (МС). На всех этапах НР могут присутствовать недуги, хотя их распространенность возрастает с возрастом, с продолжительностью болезни и в прогрессивных фенотипах. Патофизиология дисфагии в MS, вероятно, объясняется сочетанием различных факторов, включая участие кортикобулбарных трактатов, мозжечка и мозговой стеблей. Точный диагноз и раннее лечение расстройств, связанных с глотанием, повышают качество жизни и могут откладывать осложнения или инвазивные терапевтические меры. Здесь мы приводим обзор патофизиологии, оц

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… In the last year, chemical myotomy of the UES by using BoNT/A injection into the hyperactive CP muscle has been proposed as a less invasive alternative to surgical myotomy ( 34 , 48 ). … Notably, in patients with severe dysphagia resistant to swallowing therapies, UES hyper-activity may be suspected, warranting consideration of targeted treatments (i.e., surgical myotomy or BoNT/A injection) ( 47–49 ). …

Jackhammer esophagus: Clinical presentation, manometric diagnosis, and therapeutic results-Results from a multicenter French cohort.

BACKGROUND/AIMS: Jackhammer esophagus (JE) is a hypercontractile esophageal motor disorder defined by at least two swallows with a distal contractile integral (DCI) >8000 mm Hg.s.cm during high-resolution manometry (HRM). The relationship between symptoms and hypercontractility and the response to therapies have been poorly evaluated. The aim of this study was to determine the clinical presentation, manometric diagnosis, and therapeutic results in a large cohort of JE patients. METHODS: Patients with JE diagnosed among the HRM tests performed in nine academic French centers from 01/01/2010 to