• 제목/요약/키워드: Recurrent achalasia

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Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand

  • Tharathorn Suwatthanarak;Chainarong Phalanusitthepa;Chatbadin Thongchuam;Thawatchai Akaraviputh;Vitoon Chinswangwatanakul;Thikhamporn Tawantanakorn;Somchai Leelakusolvong;Monthira Maneerattanaporn;Piyaporn Apisarnthanarak;Jitladda Wasinrat
    • Clinical Endoscopy
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    • 제57권5호
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    • pp.610-619
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    • 2024
  • Background/Aims: Achalasia is a rare esophageal motility disease, for which peroral endoscopic myotomy (POEM) has emerged as a promising treatment option; however, recurrence remains a challenge. Timed barium esophagography (TBE) is a useful diagnostic tool and potential outcome predictor of achalasia. This study aimed to determine predictive tools for recurrence after POEM. Methods: This retrospective study enrolled achalasia patients who underwent POEM between January 2015 and December 2021. Patients were categorized into two groups using the 1-month post-POEM Eckardt scores and TBE: the discordant group (Eckardt score improved >50%, TBE decreased <50%) and the concordant group (both Eckardt score and TBE improved >50%). Recurrence was defined as a reincrease in the Eckardt score to more than three during follow-up. Results: Complete medical records were available in 30 patients who underwent POEM. Seventeen patients (56.7%) were classified into the discordant group, while 13 patients (43.3%) were in the concordant group. The overall recurrence rate was 11.9% at 1-year, increasing to 23.8% during the extended follow-up. The discordant group had a 6.87 fold higher recurrence rate than the concordant group (52.9% vs. 7.7%, p=0.017). Conclusions: These results strongly suggest that combining the Eckardt score with TBE can effectively predict recurrent achalasia after POEM. Patients in the discordant group had an elevated risk.

Achalasia 의 외과적 치료 -Modified Heller Operation을 시행한 9례의 관찰성적- (Surgical Treatment of Achalasia of the Esophagus -Report of 9 Cases Performed Modified Heller Operation-)

  • 이호일
    • Journal of Chest Surgery
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    • 제1권1호
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    • pp.53-60
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    • 1968
  • Achalasia is a functional disorder of a short segment of the lower esophagus showing obstruction of the esophagogastric junction. Dysphagia. regurgitation and weight loss are outstanding features,however, complicated pulmonary troubles aspiration pneumonitis, bronchiectasis, lung abscess etc. --are sometimes more apparent than the disease entity in children though achalasia is rarely encountered in children. During the period of January, 1961, to May, 1968, the authors experienced 9 cases of achalasia of the esophagus in Chest Surgery Department,N.M.C. 1. Seven of nine were male and four were under 5 years of age. 2. So-called symptoms triad noted in almost every case, and 3 of 4 children showed recurrent attacks of pneumonitis. 3. Chest film showed widened superior mediastinum by dilated esophagus in 6 cases, and pulmonary infiltrations in 3 cases of children. 4. Preoperative diagnosis were achalasia,esophageal stricture by rodent-cidal ingestion and suggestive esophageal cancer in 7 cases,one case and remaining one case. respectively. 5. Modified Heller procedure was performed in all cases with definite diagnosis of achalasia at operation table in misdiagnosed 2 cases. 6. Immediate postoperative complications were 2 cases of wound infection and one case of atelectasis and no operative mortality encountered. 7. Seven of nine showed excellent result of operation, and good in one case. Remaining one case failed relieving obstruction and underwent interposition of ileocolonic segment with excellent result.

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Subtotal Myectomy for Recurrent Cricopharyngeal Dysphagia in a Dog

  • Hong, Sung-jin;Park, Sung-guon;Kim, Sang-yeoun;Moon, Hee-sup;Park, Wan-sang;Kim, Jun-su;Kang, Sung-hun;Lee, Jae-hoon
    • 한국임상수의학회지
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    • 제34권4호
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    • pp.291-294
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    • 2017
  • An 8-month-old Chow-Chow dog presented with dysphagia and regurgitation, and was diagnosed with cricopharyngeal dysphagia (CPD). Cricopharyngeal myotomy did not improve the clinical signs. Three months after the initial surgery, a subtotal myectomy of cricopharyngeal muscle with partial thyropharngeal myotomy was performed. The clinical improvement was maintained for more than one year after the second surgery. Subtotal myectomy of cricopharyngeal muscle can be considered for dogs with CPD that do not respond to myotomy.