Achalasia : Diagnosis and Treatment.

Intro -- Contents -- Contributors -- Introduction -- 1: A One Hundred Year Journey: The History of Surgery for Esophageal Achalasia -- Introduction -- Early Accounts and First Attempts to Propose a Pathophysiologic Mechanism of an Elusive Disease. The Term: "Achalasia" Is Coined -- From Ineffective Esophageal Plications and Retrograde Dilatations to the Successful Cardiomyotomy: The Golden Era of Heller and Zaaijer -- Early Attempts to Approach Megaesophagus: The Rise and Fall of Esophagogastrostomy -- The Advent of the Partial Fundoplication to Prevent Gastroesophageal Reflux -- From Thoracoscopic to Laparoscopic Cardiomyotomy -- Modern Era: Standardization of the Surgical Technique -- Robotic Surgery, Single Site Surgery, and POEM: The Future? -- Conclusions -- References -- 2: Pathophysiology of Achalasia -- References -- 3: Clinical Presentation and Diagnostic Evaluation -- Introduction -- Symptom Evaluation -- Dysphagia -- Regurgitation and Aspiration -- Heartburn -- Chest Pain -- Symptom Scores -- Diagnostic Evaluation -- Upper Endoscopy -- Barium Swallow -- Esophageal Manometry -- Ambulatory 24-h pH Monitoring -- References -- 4: Achalasia and Chagas' Disease -- Introduction -- Clinical Presentation -- Esophageal Motility -- Esophageal Body -- Lower Esophageal Sphincter -- Esophageal Dilation -- Mucosal Abnormalities -- Pathology -- Diverticulum Formation -- Cancer Risk -- Treatment -- Preoperative Evaluation -- Endoscopic Treatment -- Dilatation -- Botulinum Toxin -- Surgical Treatment -- Heller's Myotomy -- Other Conservative Techniques -- Cardioplasty, Vagotomy and Roux-en-­Y Gastrectomy -- Esophagectomy -- Esophageal Mucosectomy and Endomuscular Pull-Through -- Conclusions -- References -- 5: Botulinum Toxin for Achalasia -- Introduction -- History -- Chemistry -- Mechanism of Action -- Medical Use -- Side Effects and Contraindications.

Method for Treating Achalasia -- Clinical Evidence -- Which BoNT Patients Do Better? -- Summary -- References -- 6: Pneumatic Dilation -- History -- Technique of Pneumatic Dilation -- Summary of Data Regarding Efficacy -- Predictors of Success -- Complications -- References -- 7: Peroral Endoscopic Myotomy -- Introduction -- Indications -- Preoperative Testing -- Technique -- Post-operative Care -- Outcomes -- Conclusions -- References -- 8: Heller Myotomy for Achalasia. From the Thoracoscopic to the Laparoscopic Approach -- Introduction -- The Open Approach -- From the Thoracoscopic to the Laparoscopic Heller Myotomy -- New Trends in Heller Myotomy -- References -- 9: Laparoscopic Heller Myotomy and Fundoplication. What Type? -- Treatment of Esophageal Achalasia. The Open Era -- Treatment of Esophageal Achalasia. The Minimally Invasive Surgery Era -- Laparoscopic Heller Myotomy. Is a Fundoplication Necessary? -- Which Fundoplication? Partial Versus Total Fundoplication -- Partial Fundoplication. Anterior Versus Posterior -- Conclusions -- References -- 10: Laparoscopic Heller Myotomy and Dor Fundoplication -- Positioning of the Patient -- Placement of the Trocars -- Division of the Gastrohepatic Ligament, Identification of the Right Crus of the Diaphragm and the Posterior Vagus Nerve -- Division of the Peritoneum, Phrenoesophageal Membrane Above the Esophagus, Identification of the Left Crus and the Anterior Vagus Nerve -- Division of the Short Gastric Vessels -- Esophageal Myotomy -- Dor Fundoplication -- Postoperative Care -- Outcome -- References -- 11: Laparoscopic Heller Myotomy with Toupet Partial Posterior Fundoplication -- Introduction -- Workup and Indications for Esophagogastric Myotomy -- Technique of Esophagogastric Myotomy -- Patient Preparation -- Patient Positioning -- Trocar Placement -- Dissection and Mobilization.

Performance of the Myotomy -- Intraoperative Assessment of the Myotomy -- Creation of the Toupet Fundoplication -- Postoperative Management -- Outcomes of Extended Esophagogastric Myotomy -- Conclusion -- References -- 12: Achalasia and Epiphrenic Diverticulum -- Introduction -- Clinical Presentation -- Diagnostic Testing -- Indications for Surgery -- Choice of Surgical Approach -- Results of Thoracoscopic and Laparoscopic Approaches -- Conclusions -- References -- 13: Thoracoscopic Treatment of Epiphrenic Diverticula Associated with Achalasia -- Introduction -- Operative Procedure -- Results -- References -- 14: The Surgical Management of Achalasia in the Morbid Obese Patient -- Introduction -- Clinical-Case Scenario 1 -- Operative Planning -- Heller Myotomy -- Creation of the Gastric Pouch -- Clinical-Case Scenario 2 -- Discussion and Brief Review of the Literature -- Conclusions -- References -- 15: Treatment of Achalasia in Patients with Dilated Esophagus -- Introduction -- Background -- Esophagectomy -- Heller Myotomy -- Technical Aspects -- Heller Myotomy -- Mediastinal Dissection -- Closure of the Esophageal Hiatus -- Partial Fundoplication -- Esophagectomy -- Conclusions -- References -- 16: Evaluation and Treatment of Patients with Recurrent Dysphagia After Heller Myotomy -- Introduction -- Recurrent Dysphagia -- Diagnostic Evaluation -- Treatment -- Pneumatic Balloon Dilatation -- Revisional Surgery -- Esophagectomy -- Alternative Treatment Modalities -- Conclusions -- References -- 17: Esophageal Resection for End-Stage Achalasia -- Introduction -- Indications -- Operative Technique -- Gastric, Colonic and Jejunal Conduit -- Gastric Conduit -- Colonic Conduit -- Jejunal Conduit -- Surgical Approach -- Mobilization of the Esophagus -- Vagal-Sparing Esophagectomy -- Trans-Thoracic Esophagectomy -- Trans-Hiatal Esophagectomy.

Anastomotic Technique -- Short Segment Esophagectomy -- Outcomes -- Perioperative Complications -- Long-Term Effects -- Conclusions -- References -- 18: Achalasia and Eating Disorders -- Introduction -- Conclusion -- References -- 19: Pediatric Achalasia -- Introduction -- Diagnostic Workup -- Barium Swallow Study -- Esophageal Manometry -- Endoscopy -- Other Diagnostic Modalities -- Therapy and Outcomes -- Medical/Pharmacologic -- Endoscopic Botox Injection -- Endoscopic Balloon Dilation -- Surgical Myotomy -- Per Oral Endoscopic Myotomy (POEM) -- References -- Index.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2024. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.