OBJECTIVES The impact of preoperative endoscopic therapy on the difficulty of laparoscopic Heller myotomy and the impact of the difficulty of the myotomy on long-term outcome has not been determined. This study was undertaken to determine whether preoperative therapy impacts the difficulty of laparoscopic Heller myotomy and whether preoperative therapy or difficulty of myotomy impacts long-term...

OBJECTIVE To evaluate the influence of primary myotomy on characteristics of the neoglottis in patients after laryngectomy. DESIGN Patient survey. SETTING University Medical Center St Radboud, Nijmegen, the Netherlands. PATIENTS Nineteen consecutive patients who underwent laryngectomy (12 with primary lateral myotomy of the upper esophageal sphincter [marked by metal clips]; 7 not requiri...

BACKGROUND AND OBJECTIVES Minimally invasive surgical techniques are applicable to achalasia, but the optimum approach to intraoperative assessment of adequacy of myotomy remains unestablished. We set out to show that videoscopic Heller myotomy with concurrent endoscopy ensures adequacy of myotomy while limiting postoperative clinically apparent reflux. METHODS Seventy-eight consecutive patie...

BACKGROUND Peroral endoscopic myotomy has recently been developed and performed on patients with good results. AIMS To evaluate the technical feasibility of peroral endoscopic full-thickness and partial thickness myotomy in a porcine model. MATERIAL AND METHODS Eighteen criollo pigs were randomly assigned to 2 groups: group A (partial-thickness myotomy) and group B (full-thickness myotomy)....

BACKGROUND Esophageal achalasia is the most common primary esophageal motor disorder. Laparoscopic Heller's myotomy combined with fundoplication represents the treatment of choice for this disease, achieving good results in about 90% of patients. However, about 10% of treated patients refer persistent or recurrent dysphagia. Many Authors showed that this failure rate is related to inadequate my...

Peroral endoscopic myotomy (POEM) is a form of transluminal natural orifice surgery (NOTES) that uses the beginnings submucosal endoscopy to make equivalent surgical myotomy. POEM can be done in most patients who have primary idiopathic achalasia demonstrated manometrically symptomatic. Previous therapies for achalasia, such as pneumatic balloon dilation, botulinum toxin injection, or myotomy, ...

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...

OBJECTIVES To review transabdominal esophagocardiomyotomy (surgical treatment of achalasia) of the esophagus and to compare outcomes of partial anterior vs partial posterior fundoplication. DATA SOURCES An electronic search was conducted among studies published between January 1976 and September 2011 using the keywords achalasia, myotomy, antireflux surgery, and fundoplication. STUDY SELECT...