Foregut (Thousand Oaks, Calif.)最新文献_第10页

Symptom Profile, Proton Pump Inhibitor Therapy, and Diagnostic Testing in Patients With Persistent Reflux-Like Symptoms: Results From a Population-Based Survey 持续反流样症状患者的症状概况、质子泵抑制剂治疗和诊断测试:一项基于人群的调查结果

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-27 DOI: 10.1177/26345161231173643

D. Armstrong, S. Srinivasan, Ceciel Rooker, P. Sinclair, E. Taylor, Prateek Sharma

{"title":"Symptom Profile, Proton Pump Inhibitor Therapy, and Diagnostic Testing in Patients With Persistent Reflux-Like Symptoms: Results From a Population-Based Survey","authors":"D. Armstrong, S. Srinivasan, Ceciel Rooker, P. Sinclair, E. Taylor, Prateek Sharma","doi":"10.1177/26345161231173643","DOIUrl":"https://doi.org/10.1177/26345161231173643","url":null,"abstract":"Proton pump inhibitors (PPIs) are highly effective in treating gastroesophageal reflux disease (GERD). However, persistent, troublesome reflux symptoms despite PPI use are common, and a proportion of individuals with these persistent symptoms is considered to have refractory GERD (rGERD). There are limited data on patients’ experience with persistent reflux-like symptoms to guide healthcare professionals in managing this troublesome condition. An international, population-based, online survey was conducted among adults who reported persistent reflux-like symptoms; 24 questions were posed regarding the participants’ symptoms, diagnosis, treatment, and comorbid conditions. Descriptive analyses were performed to characterize participants’ experience with diagnosis and their satisfaction with treatment. All data were self-reported. Of 565 initial respondents, 283 (51%) answered the question regarding being formally diagnosed by a healthcare professional with GERD and/or rGERD. The 197 (70%) participants who answered “yes” made up the survey population. Heartburn (65%) and acid regurgitation (62%) were the most common troublesome symptoms. PPI use was reported by 145 (74%) respondents, but only 30% were satisfied with PPI therapy. The most common alternative therapies included antacid/alginates (63%), histamine H2-receptor antagonists (33%), mucosal protectants (25%), and lifestyle modifications (84%). In this population-based survey, nearly one-third of participants with persistent reflux-like symptoms had not received a formal diagnosis of GERD or rGERD. Although most participants diagnosed with GERD/rGERD had received PPI therapy, persistent symptoms, dissatisfaction with PPI therapy, and concerns about long-term PPI use were common. These data emphasize the need for patient input when developing management strategies for GERD and persistent reflux-like symptoms or rGERD.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43728981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopy and Antireflux Surgery: A Technical Review of Pre- and Postoperative Evaluation and Recognizing Patterns of Failure 内镜和抗反流手术：术前和术后评估和识别失败模式的技术综述

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-19 DOI: 10.1177/26345161231174246

C. Dunn, Sven E. Eriksson, B. Jobe, S. Ayazi

{"title":"Endoscopy and Antireflux Surgery: A Technical Review of Pre- and Postoperative Evaluation and Recognizing Patterns of Failure","authors":"C. Dunn, Sven E. Eriksson, B. Jobe, S. Ayazi","doi":"10.1177/26345161231174246","DOIUrl":"https://doi.org/10.1177/26345161231174246","url":null,"abstract":"Endoscopic evaluation after antireflux surgery is a challenge, due to the complexity of anatomy, variations in anatomical repairs, and the various patterns of failure. Studies have demonstrated that endoscopy reports of postoperative examinations are often inaccurate and inconsistent. The key to consistent high quality endoscopic examinations of the integrity of an antireflux surgery is a sound foundation in the native anatomical gastroesophageal junction and an understanding of the anatomy of the various postoperative configurations. This review will clarify the critical details necessary to perform a detailed endoscopic evaluation of the patient with suspected gastroesophageal reflux, and highlight key features to distinguish the intact repair from the dysfunctional one. It first explores the anatomical components of the native gastroesophageal junction and the unique geometric architecture that manifests in the physiologic reflux barrier. Then details the essential structures to evaluate and techniques to perform in an endoscopic examination prior to an antireflux surgery. It then systematically examines the altered anatomy and postoperative changes in endoscopic appearance after Nissen, Toupet, and Dor fundoplication, Collis gastroplasty, magnetic sphincter augmentation, and transoral incisionless fundoplication. Finally, to aid in the endoscopic diagnosis of specific dysfunction, it discusses the various patterns of failure after antireflux surgery, their characteristic endoscopic appearances, and the most useful adjunct testing modalities to augment the endoscopic examination when diagnosis is unclear.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42887781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Benign Esophageal Disorders: The Thing About Race and Ethnicity 良性食道疾病:关于种族和民族的事情

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-18 DOI: 10.1177/26345161231171379

A. Addo, Kevin Connors, A. Park

引用次数: 1

Delayed Esophagectomy is Associated With Inferior Survival: A National Cancer Database Study 延迟食管切除术与低生存率相关：一项全国癌症数据库研究

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-09 DOI: 10.1177/26345161231171846

D. Dolan, Nithya Kanagasegar, Gianna Dingillo, Christine E. Alvarado, Avanti Badrinathan, A. Bassiri, Jonathan D Rice, Jillian N. Sinopoli, Leonidas Tapias, P. Linden, C. Towe

{"title":"Delayed Esophagectomy is Associated With Inferior Survival: A National Cancer Database Study","authors":"D. Dolan, Nithya Kanagasegar, Gianna Dingillo, Christine E. Alvarado, Avanti Badrinathan, A. Bassiri, Jonathan D Rice, Jillian N. Sinopoli, Leonidas Tapias, P. Linden, C. Towe","doi":"10.1177/26345161231171846","DOIUrl":"https://doi.org/10.1177/26345161231171846","url":null,"abstract":"Locoregionally advanced esophageal cancer is typically treated with neoadjuvant chemoradiation followed by surgery 4 to 8 weeks later. Occasionally surgery is delayed >12 weeks; outcomes of this approach are not well studied. We hypothesized that delayed esophagectomy after chemoradiation would have inferior long-term overall survival relative to planned trimodality esophagectomy. Adult patients with locally advanced esophageal cancer (T2−4aN0M0, T0−4aN+M0) who received multi-agent chemotherapy, radiation, and esophagectomy were identified in the 2018 National Cancer Database. Esophagectomy performed within 90 days from end of chemoradiation were categorized as “trimodality” and those ≥90 days were categorized as “delayed.” Primary outcome was overall survival measured using Kaplan-Meier estimates and Cox proportional hazard models. Secondary outcomes included surgical margin status, hospital length of stay, and readmission. Included were 19 698 patients, 3905 (19.8%) “delayed.” Median time to surgery for trimodality patients was 51 days (IQR 41-63) versus 110 days (IQR 98-131) for delayed patients. Delayed patients tended to be older, non-white, have non-private insurance, and have more comorbidities. Overall survival was shorter for delayed patients (34.8 months) versus trimodality patients (43.1 months, P ≤ .001). In multivariable analysis, delay was associated with inferior overall survival (HR 1.15, 95% CI 1.08-1.23). Length of stay and readmission rate were similar between cohorts, but delay was associated with a higher rate of positive surgical margins (6.7% vs 4.6%, P ≤ .001). In the National Cancer Database, delayed esophagectomy is associated with inferior long-term survival. Nonetheless, delayed esophagectomy may be appropriate for select patients; further research is needed to identify the optimal approach.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49328290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sex Differences in Clinical Presentation and Management in Eosinophilic Esophagitis 嗜酸性粒细胞性食管炎的临床表现和治疗的性别差异

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-08 DOI: 10.1177/26345161231170590

Rhea Fogla, E. Glaubitz, Sanam Bhatia, Arjun Ravishankar, C.Yang Andy, R. Niec, P. Katz

{"title":"Sex Differences in Clinical Presentation and Management in Eosinophilic Esophagitis","authors":"Rhea Fogla, E. Glaubitz, Sanam Bhatia, Arjun Ravishankar, C.Yang Andy, R. Niec, P. Katz","doi":"10.1177/26345161231170590","DOIUrl":"https://doi.org/10.1177/26345161231170590","url":null,"abstract":"Background: Eosinophilic esophagitis (EoE) is a male predominant disease, typically presenting with dysphagia. Our goal was to investigate sex differences in clinical presentation and management of EoE. Methods: We performed a retrospective cross-sectional review of 489 EoE patients seen at NewYork Presbyterian Weill Cornell from August 2015 to August 2019. Charts were queried for age at diagnosis, symptoms at presentation, endoscopic findings, need for dilations, and medical therapy. Student t and χ2 tests were implemented to compare outcome variables of the 2 independent groups (males vs females) and logistic regressions for invariable and multivariable analyses. Results: 489 EoE patients (226 Female [F] [46.2%], 263 Male [M] [53.8%]) were reviewed. Males were more likely to present with food impaction (92 [35.8%] vs 44 [19.7%], M vs F, P < .001), have a fibrostenotic phenotype on initial endoscopy (140 [54.1%] vs 98 [45.0%], M vs F, P = .043) and undergo dilation (odds ratio [OR] = 1.985, 95% confidence interval [CI] = 1.209-3.328, P < .01). Female patients were more likely to have atopic disease (153 [67.6%] vs 153 [58.8%], F vs M, P = .044) and a reported normal index endoscopy (79 [36.2%] vs 69 [26.6%], F vs M, P = .026). Conclusion: This large retrospective review highlights clinically important differences in presentation between sexes. Increasing awareness of these differences, especially history of atopic disease, impaction, and the need for dilation, can help clinicians better identify EoE in female patients and therefore, guide initial therapy. The mechanistic underpinnings of these discrepancies are not evident from this data and will require future studies.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"13 1","pages":"141 - 148"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79102158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

American Foregut Society White Paper on Transoral Incisionless Fundoplication 美国前肠学会关于经口无切口手术的白皮书

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-02 DOI: 10.1177/26345161231170788

Olaya I. Brewer Gutierrez, David Choi, R. Hejazi, Salih Samo, Michael N. Tran, K. Chang, Glenn M. Ihde, R. Bell, N. Nguyen

引用次数: 2

Health Disparities and Precision Oncology in Foregut Malignancies 前肠恶性肿瘤的健康差异和精确肿瘤学

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-02 DOI: 10.1177/26345161231170660

E. M. Dowell, David H. Wang

引用次数: 1

Gastroesophageal Reflux Disease: Critical Aspects of the History 胃食管反流病：历史的关键方面

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-02 DOI: 10.1177/26345161231170287

F. Banki

引用次数: 0

Critical Decision Making: Dysphagia 关键决策:吞咽困难

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-02 DOI: 10.1177/26345161231170244

Shreya Chablaney, L. Brandt

引用次数: 0

Symptoms Evaluation After Anti-Reflux Surgery—Gi Perspective 抗反流手术后的症状评估——Gi视角

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-04-28 DOI: 10.1177/26345161231170586

S. Chandra, S. Reddymasu

引用次数: 0