Posts Tagged ‘Myotomy

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, […]

The 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 […]

Idiopathic 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 […]

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