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EFFECT OF PREVIOUS TREATMENT ON SURGICAL OUTCOME Patients unsuccessfully treated by endoscopic dilation or in- trasphinteric botulinum toxin injection are often referred for surgery. Transient tissue damage in the mucosa-submucosa layer has been documented by high resolution endoscopic ultrasonography, but it is unknown whether previous endoscopic treatment may cause histopathological changes leading to periesophageal inflammation, [...]
Achalasia: Dilation, injection or surgery? INJECTION
15, Jan 2012The results of a double-blind trial of intrasphincteric injection of botulinum toxin compared with placebo showed that 66% of patients remained in remission six months after treatment, and the mean duration of a favourable response was 1.3 years. After a median follow-up of 2.4 years, only one-third of the patients were still in remission despite [...]
Current treatment modalities for achalasia are palliative and aim at improving esophageal emptying by reducing lower esophageal sphincter resistance to passage of the bolus. This effect can be achieved endoscopically by means of either pneumatic dilation or botulinum toxin injection, and surgically by extramucosal myotomy. No firm consensus has been reached yet regarding the choice [...]
Achalasia: Dilation, injection or surgery?
13, Jan 2012Idiopathic achalasia is a motility disorder characterized by incomplete relaxation of the lower esophageal sphincter and impaired peristalsis of the esophageal body. Defective eso- phageal emptying leads to progressive dilation and tortuosity of the esophagus. Anatomic and physiological studies suggest a dysfunction of the myenteric plexus in these patients, and an autoimmune pathogenesis has been [...]
This study suggests that using community supports contributes to a better subjective outcome of surgery for IBD. Use of supportive resources was correlated with a higher quality of life in our sample, which is consistent with the reported value of social support for medical outcomes in general. Furthermore, the survey data suggest that in a [...]
- In: Disease
- Tags: Community resources, Inflammatory bowel disease, Surgery
Of 92 subjects who completed both the resource questionnaire and the IBDQ, 43 (47%) were men and 49 (53%) were women. The mean age was 38.0 years (range 17 to 71 years). The mean age at onset of symptoms was 27.6 years (range six to 68 years). Forty-six (50%) had ulcerative colitis, while 43 (47%) [...]
- In: Disease
- Tags: Community resources, Inflammatory bowel disease, Surgery
Use of community resources before inflammatory bowel disease surgery: SUBJECTS AND METHODS
1, Jan 2012Of 219 patients who underwent surgery for Crohn’s disease or ulcerative colitis at Mount Sinai Hospital, Toronto, Ontario between September 5, 1996 and September, 29 1997, 145 could be contacted by telephone and were invited to participate in the study. Fifteen patients declined. One hundred and thirty questionnaires were distributed by mail for self-administration. Participants [...]
- In: Disease
- Tags: Community resources, Inflammatory bowel disease, Surgery