Cristin-resultat-ID: 1588483
Sist endret: 18. mars 2019, 18:04
NVI-rapporteringsår: 2018
Resultat
Vitenskapelig artikkel
2018

Navigated retrograde endoscopic myotomy (REM) for the treatment of therapy-resistant achalasia

Bidragsytere:
  • Khanh Do-Cong Pham
  • Roald Flesland Havre
  • Thomas Langø
  • Erlend Fagertun Hofstad
  • Geir Arne Tangen
  • Ronald Mårvik
  • mfl.

Tidsskrift

Neurogastroenterology and Motility
ISSN 1350-1925
e-ISSN 1365-2982
NVI-nivå 2

Om resultatet

Vitenskapelig artikkel
Publiseringsår: 2018
Volum: 30
Hefte: 4
Artikkelnummer: e13252
Open Access

Importkilder

Scopus-ID: 2-s2.0-85034088665

Beskrivelse Beskrivelse

Tittel

Navigated retrograde endoscopic myotomy (REM) for the treatment of therapy-resistant achalasia

Sammendrag

Background In achalasia, muscle spasm may involve the proximal esophagus. When the muscle spasm is located in the proximal esophagus, conventional per oral endoscopic myotomy (POEM) may not be sufficient to relieve symptoms. In this paper, we describe retrograde endoscopic myotomy (REM) as a novel approach to perform myotomy of the proximal esophagus, with the application of a navigation tool for anatomical guidance during REM. We aim to evaluate the feasibility and safety of REM and usefulness of the navigation during REM. Method A 42‐year‐old male with type III achalasia who was treated with laparoscopic myotomy with fundoplication, multiple pneumatic balloon dilations, Botox injections and anterior POEM of the middle and distal esophagus without symptomatic effect. Repeated high‐resolution‐ manometry (HRM) revealed occluding contractions of high amplitude around and above the aortic arch. A probe‐based real‐time electromagnetic navigation platform was used to facilitate real‐time anatomical orientation and to evaluate myotomy position and length during REM. Results The navigation system aided in identifying the major structures of the mediastinum, and position and length of the myotomy. Twelve weeks after REM, the Eckardt score fell from seven at baseline seven to two. We also observed improvement with reduction of the pressure at the level of previous spasms in the proximal esophagus from 124 mmHg to 8 mmHg on HRM. Conclusion REM makes the proximal esophagus accessible for endoscopic myotomy. Potential indication for REM is motility disorders in the proximal esophagus and therapy failure after POEM.

Bidragsytere

Aktiv cristin-person

Khanh Do-Cong Pham

  • Tilknyttet:
    Forfatter
    ved Medisinsk klinikk ved Helse Bergen HF - Haukeland universitetssykehus
  • Tilknyttet:
    Forfatter
    ved Klinisk institutt 1 ved Universitetet i Bergen

Roald Flesland Havre

  • Tilknyttet:
    Forfatter
    ved Medisinsk klinikk ved Helse Bergen HF - Haukeland universitetssykehus
  • Tilknyttet:
    Forfatter
    ved Nasjonal kompetansetjeneste for gastroenterologisk ultralyd ved Helse Bergen HF - Haukeland universitetssykehus

Thomas Langø

  • Tilknyttet:
    Forfatter
    ved Helse ved SINTEF AS
  • Tilknyttet:
    Forfatter
    ved Nasjonal kompetansetjeneste for ultralyd- og bildeveiledet behandling ved St. Olavs Hospital HF

Erlend Fagertun Hofstad

  • Tilknyttet:
    Forfatter
    ved Helse ved SINTEF AS

Geir Arne Tangen

  • Tilknyttet:
    Forfatter
    ved Helse ved SINTEF AS
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