OBJECTIVES Cricopharyngeal dysfunction may lead to severe dysphagia and aspiration. The objective of this systematic review was to evaluate the existing studies on the effectiveness of myotomy, dilatation, and botulinum toxin (BoT) injection in the management of cricopharyngeal dysphagia. METHODS PubMed and Web of Science databases were searched to identify eligible studies by using the terms...

BACKGROUND AND STUDY AIMS Peroral endoscopic myotomy (POEM) is a time-consuming and challenging procedure. Traditionally, the myotomy is done after the submucosal tunnel has been completed. Starting the myotomy earlier, after submucosal tunneling is half completed (concurrent myotomy and tunneling), may be more efficient. This study aims to assess if the method of concurrent myotomy and tunneli...

Heller myotomy is the optimal surgical management for achalasia. Recurrent or persistent symptoms after surgical myotomy can occur in approximately 10% of patients [1, 2]. Failed Heller myotomy presents a diagnostic and therapeutic challenge. An inadequate surgical myotomy is the commonest cause of failure. The appropriate treatment for failed surgical myotomy is controversial. Peroral endoscop...

Several theories on the etiology and pathophysiology of achalasia have been reported but, to date, it is widely accepted that loss of peristalsis and absence of swallow-induced relaxation of the lower esophageal sphincter are the main functional abnormalities. Treatment of achalasia often aims to alleviate the symptoms of achalasia and not to correct the underlying disorder. Medical therapy has...

Achalasia is a rare esophageal motility disorder defined as impaired relaxation of the esophagogastric junction (EGJ) and the absence of esophageal peristaltic contractions. High resolution manometry (HRM) is now the gold standard for the diagnosis of achalasia. Pandolfino et al. proposed classifying achalasia into three subtypes based on esophageal contraction patterns on HRM [1]. In the most ...

During the 1970s and the 1980s, operations for benign esophageal disorders were often withheld or delayed in favor of less effective forms of treatment in an effort to prevent the postoperative discomfort, the long hospital stay, and the recovery time associated with open surgical procedures. For instance, pneumatic dilatation became first-line therapy for achalasia, even though surgical manage...

We aimed to assess the short-term outcomes of per-oral endoscopic myotomy (POEM) compared with laparoscopic Heller myotomy (LHM) for achalasia through a meta-analysis of nonrandomized comparative studies.We searched PubMed, Embase, Medline, Cochrane Library, and Google Scholar for studies that compared POEM and LHM for achalasia and were published between January 1, 2008 and December 31, 2014. ...