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Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus

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https://read.qxmd.com/read/30715267/liquid-nitrogen-spray-cryotherapy-in-treatment-of-barrett-s-esophagus-where-do-we-stand-a-systematic-review-and-meta-analysis
#1
B P Mohan, R Krishnamoorthi, S Ponnada, M Shakhatreh, M Jayaraj, R Garg, J Law, M Larsen, S Irani, A Ross, D G Adler
Radiofrequency ablation (RFA) is the preferred treatment option for Barrett's esophagus (BE) to achieve complete eradication (CE) of dysplasia (D), and intestinal metaplasia (IM). Cryotherapy, using liquid nitrogen (LNC), is a cold-induced tissue-injury technique option for the ablation of BE. We conducted a systematic review and meta-analysis to assess the overall efficacy and safety of LNC in the treatment of BE.We conducted a search of multiple electronic databases and conference proceedings from inception through June 2018...
January 31, 2019: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30715230/management-of-eosinophilic-esophagitis-is-often-discordant-with-guidelines-and-not-patient-centered-results-of-a-survey-of-gastroenterologists
#2
Joy W Chang, Sameer D Saini, Jessica L Mellinger, Joan W Chen, Brian J Zikmund-Fisher, Joel H Rubenstein
Published guidelines for the management of eosinophilic esophagitis (EoE) recommend an initial trial of proton pump inhibitors (PPI), histologic assessment for response to therapy, and tailoring treatments to patient needs and provider resources. Effectiveness studies directly comparing therapies are lacking, leaving a situation ripe for shared decision making. We aimed to assess gastroenterologists' adherence to guidelines and how they respond to EoE patients' preferences regarding management. We administered a web-based survey to practicing US gastroenterologists, assessing knowledge, and practice patterns in the management of EoE, including comfort with alternative treatments to steroids...
January 31, 2019: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30715227/the-impact-of-gastroesophageal-reflux-disease-symptoms-in-scleroderma-effects-on-sleep-quality
#3
J L Horsley-Silva, S B Umar, M F Vela, W L Griffing, J M Parish, J K DiBaise, M D Crowell
Systemic scleroderma/sclerosis (SSc) is an autoimmune connective tissue disease, which can lead to esophageal motor dysfunction and gastroesophageal reflux disease (GERD). Nocturnal GERD symptoms may be associated with sleep disturbances, which in turn can drastically affect well-being and fatigue levels. We hypothesized that GERD symptoms would be associated with poorer sleep in patients with SSc.Rheumatologist established SSc patients completed the following questionnaires: the UCLA scleroderma clinical trial consortium gastrointestinal tract instrument (GIT) 2...
January 31, 2019: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30715226/a-competing-risks-nomogram-and-recursive-partitioning-analysis-for-cause-specific-mortality-in-patients-with-esophageal-neuroendocrine-carcinoma
#4
G Zhang, B Wu, X Wang, J Li
The objective of this study is to estimate the probability of cause-specific mortality using a competing-risks nomogram and recursive partitioning analysis in a large population-based cohort of patients with esophageal neuroendocrine carcinoma. The surveillance, epidemiology and end results database was used to identify 162 patients diagnosed with esophageal neuroendocrine carcinoma from 1998 to 2014. We estimated a cumulative incidence function for cause-specific mortality. A nomogram was constructed by using a proportional subdistribution hazard model, validated using bootstrap cross-validation, and evaluated with a decision curve analysis to assess its clinical utility...
January 31, 2019: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30597022/intensity-modulated-radiotherapy-at-high-volume-centers-improves-survival-in-patients-with-esophageal-adenocarcinoma-receiving-trimodality-therapy
#5
G Q Yang, R Mhaskar, A Rishi, A O Naghavi, J M Frakes, K Almhanna, J Fontaine, Jose M Pimiento, Sarah E Hoffe
The standard of care trimodality therapy for resectable locally advanced esophageal adenocarcinoma is complex and necessitates multidisciplinary care and expertise. In this work, it is hypothesized that facility clinical volume and utilization of intensity-modulated radiotherapy (IMRT) may influence outcomes. The National Cancer Data Base was queried for patients with cT1-4-N0-3 M0 esophageal adenocarcinoma undergoing trimodality therapy from 2004 to 2013 (n = 2445). All patients received chemoradiation followed by esophagectomy at a Commission on Cancer facility...
December 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30596966/validation-of-instruments-for-the-assessment-of-dysphagia-due-to-malignancy-of-the-esophagus
#6
J Persson, C Engström, H Bergquist, E Johnsson, Ulrika Smedh
The aim of the study was to validate the Watson scale, the Ogilvie scale, and the Goldschmid scale for assessment of dysphagia due to malignancy of the esophagus. After translation of the scales to Swedish, 35 patients with dysphagia due to esophageal malignancy were asked to participate. On day 1, patients were asked to fill in the questionnaires. The patients also kept a food diary for 4 consecutive days, for assessment of actual swallowing ability. On day 10, the patients were asked to fill in the scales again, to control for individual variability...
December 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30596963/preemptive-endoluminal-vacuum-therapy-to-reduce-anastomotic-leakage-after-esophagectomy-a-game-changing-approach
#7
C Gubler, D Vetter, H M Schmidt, P C Müller, B Morell, D Raptis, C A Gutschow
Endoluminal vacuum therapy (EVT) is an accepted treatment for anastomotic leakage (AL) after esophagectomy. A novel concept is to use this technology in a preemptive setting, with the aim to reduce the AL rate and postoperative morbidity. Preemptive EVT (pEVT) was performed intraoperatively in 19 consecutive patients undergoing minimally invasive esophagectomy, immediately after completion of esophagogastrostomy. Twelve patients (63%) were high-risk cases with severe comorbidity. The EVT device was removed routinely three to six (median 5) days after esophagectomy...
December 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30596900/the-overall-metastatic-rate-in-early-esophageal-adenocarcinoma-long-time-follow-up-of-surgically-treated-patients
#8
C Oetzmann von Sochaczewski, T Haist, M Pauthner, M Mann, A Fisseler-Eckhoff, S Braun, C Ell, D Lorenz
The overall metastatic potential of surgically treated early esophageal adenocarcinoma has not been studied in detail. This paper therefore assessed lymph node metastases at surgery, loco regional and distant metastases, in order to assess the metastatic potential of early esophageal adenocarcinoma. Two hundred and seventeen patients (53 T1a, 164 T1b; median follow-ups 87 and 75 months, 187 males) diagnosed with early esophageal adenocarcinoma and treated with esophagectomy in our tertiary center's database between July 2000 and December 2015 were included...
December 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30596899/outcomes-of-octogenarians-with-esophageal-cancer-an-analysis-of-the-national-cancer-database
#9
C T Bakhos, A C Salami, L R Kaiser, R V Petrov, A E Abbas
The optimal treatment of esophageal cancer in octogenarians is controversial. While the safety of esophagectomy has been demonstrated in elderly patients, surgery and multimodality therapy are still offered to a select group. Additionally, the long-term outcomes in octogenarians have not been thoroughly compared to those in younger patients. We sought to compare the outcomes of esophageal cancer treatment between octogenarians and non-octogenarians in the National Cancer Database (2004-2014). The major endpoints were early postoperative mortality and long-term survival...
December 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561659/epidural-analgesia-after-minimally-invasive-esophagectomy-efficacy-and-complication-profile
#10
B F Kingma, E Visser, M Marsman, J P Ruurda, R van Hillegersberg
Adequate postoperative pain management is essential to facilitate uneventful recovery after esophagectomy. Although epidural analgesia is the gold standard, it is not satisfactory in all patients. The aim of this study is to describe the efficacy and complication profile of epidural analgesia after minimally invasive esophagectomy (MIE). A total of 108 patients who underwent a robot-assisted (McKeown) MIE for esophageal cancer were included from a single center prospective database (2012-2015). The number of patients that could receive epidural analgesia, the sensory block range per day, the number of epidural top-ups, the need for escape pain mediation (i...
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561611/reply-to-letter-neoadjuvant-chemoradiotherapy-or-chemotherapy-for-esophageal-cancer-what-is-the-current-evidence
#11
G A von Döbeln, F Klevebro, M Nilsson
No abstract text is available yet for this article.
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561608/efficacy-of-triamcinolone-soaked-polyglycolic-acid-sheet-plus-fully-covered-metal-stent-for-preventing-stricture-formation-after-large-esophageal-endoscopic-submucosal-dissection
#12
L Li, E Linghu, N Chai, Z Li, J Zou, C Du, X Wang, J Xiang
Esophageal stricture is a major problem for patients with large superficial esophageal squamous cell neoplasms (SESCNs) after endoscopic submucosal dissection (ESD). Although many measures could be used as prophylaxis for post-ESD strictures, a well-accepted method has not yet been established. We propose using a triamcinolone-soaked polyglycolic acid sheet plus fully covered metal stent (TS-PGA+FCMS) as a novel method to prevent stricture formation after large esophageal ESD. From June 2016 to May 2017, nine patients with SESCNs (≥3/4 of the esophageal circumference) who underwent TS-PGA+FCMS placement immediately after ESD and did not require additional surgical resection were enrolled in this case series...
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561590/evolution-of-the-surgical-technique-of-minimally-invasive-ivor-lewis-esophagectomy-description-according-to-the-ideal-framework-but-which-ideal-stage
#13
A Hirst, P McCulloch
No abstract text is available yet for this article.
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561588/effervescent-agents-in-acute-esophageal-food-impaction
#14
J David, D Backstedt, K J O'Keefe, K Salehpour, R D Gerkin, F C Ramirez
Acute esophageal food impaction (AEFI) occurs frequently. Few data are published describing the use of effervescent agents (EAs) for treatment of AEFI. We aimed to evaluate the effectiveness, cost, and safety of EAs in the treatment of AEFI. We retrospectively identified patients aged 18 years and older who were seen in the emergency department of 2 hospitals in 1 metropolitan area from January 1, 2011, through April 4, 2016, who had a clinical diagnosis of AEFI. We collected and analyzed data on outcomes and cost associated with the use of EAs, glucagon, and no pharmacologic therapy...
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561585/does-demeester-score-still-define-gerd
#15
R M L Neto, F A M Herbella, F Schlottmann, M G Patti
Gastroesophageal reflux disease (GERD) clinical presentation may encompass a myriad of symptoms that may mimic other esophageal and extra-esophageal diseases. Thus, GERD diagnosis by symptoms only may be inaccurate. Upper digestive endoscopy and barium esophagram may also be misleading. pH monitoring must be added often for a definitive diagnosis. The DeMeester score (DMS) is a composite score of the acid exposure during a prolonged ambulatory pH monitoring that has been used since 1970s to categorize patients as GERD+ or GERD-...
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561584/intraoperative-pyloric-botulinum-toxin-injection-during-ivor-lewis-gastroesophagectomy-to-prevent-delayed-gastric-emptying
#16
J C Tham, M Nixon, A V Ariyarathenam, L Humphreys, R Berrisford, T Wheatley, G Sanders
Delayed gastric emptying (DGE) is a common morbidity that affects 10%-50% of Ivor-Lewis gastroesophagectomy (ILGO) patients. DGE management is variable with no gold standard prevention or treatment. We conducted a study to assess the effectiveness of intraoperative pyloric botulinum toxin injection in preventing DGE. All patients undergoing an ILGO for curative intent, semi-mechanical anastomosis, and enhanced recovery between 1st December 2011 and 30th June 2017 were included. Patients with pyloroplasties were excluded and botulinum toxin was routinely given from the 2nd April 2016...
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561582/author-s-response-regarding-manuscript-evolution-of-the-surgical-technique-of-minimally-invasive-ivor-lewis-esophagectomy-description-according-to-the-ideal-framework
#17
F van Workum, C Rosman
No abstract text is available yet for this article.
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561581/an-anatomical-hypothesis-a-concentric-structured-model-for-the-theoretical-understanding-of-the-surgical-anatomy-in-the-upper-mediastinum-required-for-esophagectomy-with-radical-mediastinal-lymph-node-dissection
#18
H Fujiwara, J Kanamori, Y Nakajima, T Kawano, A Miura, T Fujita, K Akita, H Daiko
Understanding the surgical anatomy is the key to reducing surgical invasiveness especially in the upper mediastinal dissection for esophageal cancer, which is supposed to have a significant impact on curability and morbidity. However, there is no theoretical recognition regarding the surgical anatomy required for esophagectomy, although the surgical anatomy in abdominal digestive surgery has been developed on the basis of embryological findings of intestinal rotation and fusion fascia. Therefore, we developed a hypothesis of a 'concentric-structured model' of the surgical anatomy in the upper mediastinum based on human embryonic development...
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30561570/normal-radiological-lymph-node-appearance-in-the-thorax
#19
T Hansen, M Nilsson, D Lindholm, J Sundström, J Hedberg
Modern treatment of esophageal cancer is multimodal and highly dependent on a detailed diagnostic assessment of clinical stage, which includes nodal stage. Clinical appraisal of nodal stage is highly dependent on knowledge of normal radiological appearance, information of which is scarce. We aimed to describe lymph node appearance on computed tomography (CT) investigations in a randomly selected cohort of healthy subjects. In a sample of the Swedish Cardiopulmonary bioimage study, which investigates a sample of the Swedish population aged 50-64 years, the CT scans of 426 subjects were studied in detail concerning intrathoracic node stations relevant in clinical staging of esophageal cancer...
December 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/30541019/wide-area-transepithelial-sampling-with-computer-assisted-3-dimensional-analysis-wats-markedly-improves-detection-of-esophageal-dysplasia-and-barrett-s-esophagus-analysis-from-a-prospective-multicenter-community-based-study
#20
M S Smith, E Ikonomi, R Bhuta, N Iorio, R D Kataria, V Kaul, S A Gross
The 4-quadrant forceps biopsy (FB) protocol for identifying Barrett's esophagus (BE) and esophageal dysplasia (ED) suffers from poor sensitivity due to significant sampling error. We investigated the benefit of wide-area transepithelial sampling with 3-dimensional computer-assisted analysis (WATS) used adjunctively to the combination of random and targeted FB in the detection of ED, and as a secondary outcome, BE. In this multicenter prospective trial, community endoscopists at 21 sites utilized WATS as an adjunct to both targeted and random FB in patients undergoing BE screening and surveillance...
December 12, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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