Muscle layer histopathology and manometry pattern of primary esophageal motility disorders including achalasia

2016 ◽  
Vol 29 (3) ◽  
pp. e12968 ◽  
Author(s):  
N. Nakajima ◽  
H. Sato ◽  
K. Takahashi ◽  
G. Hasegawa ◽  
K. Mizuno ◽  
...  
2013 ◽  
Vol 11 (9) ◽  
pp. 1115-1121.e2 ◽  
Author(s):  
Tim Vanuytsel ◽  
Raf Bisschops ◽  
Ricard Farré ◽  
Ans Pauwels ◽  
Lieselot Holvoet ◽  
...  

2016 ◽  
Vol 40 (12) ◽  
pp. 1679-1685 ◽  
Author(s):  
Juan Putra ◽  
Kristen E. Muller ◽  
Zilla H. Hussain ◽  
Siddhartha Parker ◽  
Scott Gabbard ◽  
...  

2019 ◽  
Vol 07 (04) ◽  
pp. E525-E532
Author(s):  
Daisuke Watanabe ◽  
Shinwa Tanaka ◽  
Fumiaki Kawara ◽  
Hirohumi Abe ◽  
Ryusuke Ariyoshi ◽  
...  

Abstract Background and study aims Previously, we reported that esophageal muscle layer thickness was associated with technical complexity of peroral endoscopic myotomy (POEM). However, there are no data regarding the mid-term effects of POEM procedures on esophageal muscle layer thickness. Therefore, we conducted this study to elucidate mid-term effects of POEM procedures, and to examine whether postoperative changes in esophageal muscle layer thickness were related to particular clinico-pathological features in patients with esophageal motility disorders. Patients and methods Seventy-four consecutive patients with esophageal motility disorders who underwent POEM at Kobe University Hospital from April 2015 to December 2016 were prospectively recruited into this study. First, we investigated the esophageal muscle layer thickness values obtained at 1 year after POEM. Second, we evaluated the effects of a reduction in muscle layer thickness on various clinico-pathological features. Results At 1 year after POEM, mean thickness of the inner circular muscle at 0 cm, 5 cm, and 10 cm from the esophagogastric junction was 1.06 ± 0.45 mm, 0.99 ± 0.36 mm, and 0.97 ± 0.44 mm, respectively. Among all sites, muscle layer thickness had significantly decreased after POEM. However, univariate logistic regression analysis demonstrated that no clinical factors were associated with esophageal muscle layer thickness after POEM procedure. Conclusions We demonstrated for the first time that thickness of the esophageal muscle layer was significantly decreased after POEM. This result reveals that changes in esophageal muscle layer thickness caused by esophageal motility disorders are reversible.


2000 ◽  
Vol 41 (2) ◽  
pp. 145-150 ◽  
Author(s):  
H. Nellemann ◽  
K. Aksglaede ◽  
P. Funch-Jensen ◽  
P. Thommesen

Purpose: To evaluate the significance of bread and barium studies as a diagnostic tool as well as a supplement to manometric investigation of the esophagus in patients with suspected esophageal motility disorders. Material and Methods: Eighty-nine patients suspected for primary esophageal motility disorders were examined. All patients were interviewed before the investigation to determine the prevalence of symptoms like heartburn, chest pain, and dysphagia. The patients underwent simultaneous roentgenologic and manometric investigations in the supine position during wet and solid barium swallow, and during continuous drinking, followed by investigation for gastroesophageal reflux (GER). The manometric examination was performed with triple-lumen catheters connected to a hydraulic capillary infusion system and external transducers. Results: All patients with normal esophageal clearing (n=31) had normal manometry. Patients with delayed esophageal clearing (n=58) required manometry for identifying concommittant motility disorders; achalasia and diffuse esophageal spasms were found only in patients with delayed liquid and solid emptying. GER and/or esophageal rings was demonstrated in 31 patients. Conclusion: We suggest bread and barium as the first diagnostic step in patients with clinical suspicion of primary esophageal motility disorders.


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