Foregut (Thousand Oaks, Calif.)最新文献_第9页

The Esophagogastric Junction Integrity 食管胃交界完整性

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231170426

Salih Samo

{"title":"The Esophagogastric Junction Integrity","authors":"Salih Samo","doi":"10.1177/26345161231170426","DOIUrl":"https://doi.org/10.1177/26345161231170426","url":null,"abstract":"To the editor, I read with great interest the article “The American Foregut Society white paper on the endoscopic classification of esophagogastric junction integrity”1 published in the journal. The newly proposed American Foregut Society (AFS) classification to grade the antireflux barrier (ARB) integrity provides more comprehensive evaluation that are relevant to the practicing clinicians in day-to-day practice. The authors appropriately call for future validation of this novel classification and its correlation with the presence and severity of gastroesophageal reflux disease, and additionally to extend the classification to assess the ARB integrity in individuals with prior antireflux interventions,1 whether surgical or endoscopic. However, the future directions fall short of addressing 2 important variables that may affect the assessment of ARB integrity by applying the AFS classification. First, the classification does not take into consideration the anesthesia effect on the ARB. The hiatal aperture tends to be larger under general anesthesia with use of paralytics as compared to conscious sedation without the use of paralytics. Second, the novel AFS classification does not take obesity into consideration either. It is common to see a large fat pad in the diaphragmatic hiatus during laparoscopy, which may prevent accurate appreciation of a hidden hiatal hernia, whether endoscopically or laparoscopically. Therefore, caution needs to be taken when evaluating for hiatal hernia in obese patients, and other modalities, such as upper gastrointestinal contrast study, should be used to assess for presence of hiatal hernias.2 Addressing these 2 important issues is of paramount importance in future studies. Declaration of Conflicting Interests","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"29 1","pages":"235 - 235"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75540682","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

Sex Differences in Gastroesophageal Reflux Disease (GERD) 胃食管反流病(GERD)的性别差异

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231166136

Daniel Scheese, Mohamad Chehab, C. A. Puig

引用次数: 0

Reply to the Esophagogastric Junction Integrity 对食管胃交界完整性的回答

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231170423

N. Nguyen, K. Chang, M. Canto, J. Lipham, R. Bell, P. Kahrilas

{"title":"Reply to the Esophagogastric Junction Integrity","authors":"N. Nguyen, K. Chang, M. Canto, J. Lipham, R. Bell, P. Kahrilas","doi":"10.1177/26345161231170423","DOIUrl":"https://doi.org/10.1177/26345161231170423","url":null,"abstract":"We thank the reader for their letter and interest in the American Foregut Society (AFS) endoscopic classification of esophagogastric junction (EGJ) integrity.1,2 The reader raised 2 issues regarding potential limitations of our approach. First, it does not consider the effect of anesthesia and the reader commented on the observation that the hiatal aperture tends to enlarge under general anesthesia with the use of paralytics as compared to conscious sedation endoscopy. While this observation is interesting, we are not advocating doing routine upper endoscopy under general anesthesia. It is also worth noting that we were more driven by endoscopic undergrading of hiatal integrity due to insufficient gastric insufflation rather than overgrading, even going so far as to advocate eliciting a hernia with a provocative endoscopic maneuver. The second observation from the reader is that obese patients commonly have a large fat pad at the level of the hiatus that may preclude an accurate depiction of the hiatal defect. We agree that this can lead to “undergrading” the EGJ and should be kept in mind with obese patients. It also emphasizes the need to utilize maximal insufflation of the stomach and provocative maneuvers to elicit a sliding hiatal hernia. However even if the fat pad leads to an underestimation of the hiatus grade, it would not obscure an AFS grade II which is a key difference between AFS grading and the Hill classification. An AFS grade II is considered pathologic, representing partial hiatus disruption with loss of the intraabdominal esophageal length along with the gastroesophageal flap valve and the angle of His. In contrast, a Hill grade II is considered to be a normal finding. We thank the reader for their interest and astute comments. Declaration of Conflicting Interests","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"7 1","pages":"236 - 236"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81485456","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

Analysis of Reported Adverse Events Associated With the Use of Functional Lumen Imaging Probe Devices in the Esophagus and Stomach: An FDA MAUDE Database Study 与食道和胃使用功能性管腔成像探头装置相关的不良事件分析:FDA MAUDE数据库研究

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231191696

F. Jaber, W. Johnson, N. Wilson, Saqr Alsakarneh, Mouhand F. H. Mohamed, K. Ahmed, Nicole Patel, B. Hanson, Mohamed Abdallah, M. Bilal

引用次数: 0

The Impact of Disparities on Minimally Invasive Esophagectomy After the 2014 Affordable Care Act Expansion: A Retrospective Analysis 2014年平价医疗法案扩大后微创食管切除术差异的影响:回顾性分析

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231178351

Avanti Badrinathan, Thomas A. Syphan, A. Bassiri, J. Linden, Christine E. Alvarado, Jillian N. Sinopoli, Leonidas Tapias Vargas, C. Towe

引用次数: 0

Disparities in Benign and Malignant Foregut Disease 良性和恶性前肠疾病的差异

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231175993

V. Litle

引用次数: 0

Critical Decision Making: Endoscopic Pyloromyotomy 关键决策:内窥镜幽门切开术

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-30 DOI: 10.1177/26345161231178352

Lee L. Swanstöm

引用次数: 0

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