Surgery For Benign Oesophageal Disorders

Simic Aleksandar P; Bonavina Luigi; Demeester Steven R

BOOK

Surgery For Benign Oesophageal Disorders

Simic Aleksandar P | Bonavina Luigi | Demeester Steven R

(2017)

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Book Details

ISBN: 978-1-78634-412-0
Edition
Language: English
Pages: 313
Subjects: Gastroenterology
Otorhinolaryngology (ENT)
Surgery

Section Title	Page	Action	Price
Contents	xi
Preface	v
About the Editors	vii
Chapter 1. Perspectives of Surgery for Benign Esophageal Diseases	1
1.1. Introduction	1
1.2. Patient Related [2, 4]	2
1.3. Related to Intervention [2, 4]	2
1.4. Related to Comparison [2, 4]	3
1.5. Related to Outcomes [2, 4]	3
References	7
Chapter 2. Fundoplication for Gastroesophageal Reflux Disease	11
2.1. Introduction	11
2.2. Clinical Aspects	13
2.3. Pre-operative Evaluation	14
2.4. Indications	16
2.5. Persistent Dilemma: Type of Fundoplication	17
2.6. Laparoscopic Nissen Fundoplication	19
2.6.1. Patient positioning and trocar placement	19
2.6.2. Hiatal dissection	20
2.6.3. Crural repair and fundus mobilization	21
2.6.4. Fundoplication	22
2.7. Post-operative Care	23
2.8. Complications	24
2.9. Results	25
2.10. Conclusion	26
References	26
Chapter 3. Innovations in Minimally Invasive Therapy of GERD\r	35
3.1. Introduction	35
3.2. Endoscopic Anti-reflux Procedures	36
3.2.1. Evolution	36
3.2.2. Endoscopic plication	37
3.2.3. Remarks on endoscopic plication	39
3.3. Magnetic Sphincter Augmentation	40
3.3.1. Evolution	40
3.3.2. LINX\x02 implantation	41
3.3.3. Clinical data	41
3.3.4. LINX\x02 vs. laparoscopic fundoplication	43
3.3.5. Summary	44
3.4. Electrical Sphincter Stimulation	45
3.4.1. Evolution	45
3.4.2. EndoStim implantation	45
3.4.3. Clinical outcomes	46
3.4.4. Summary	48
References	48
Chapter 4. Reflux Strictures and Short Esophagus	55
4.1. Introduction	55
4.2. Pathophysiology of GERD and Its Relationship with RS and SE	56
4.3. Reflux Strictures	58
4.3.1. Clinical presentation of RS	59
4.3.2. Diagnosis of RS	59
4.3.3. Treatment of RS	61
4.4. Short Esophagus	62
4.4.1. The clinical “Problem” of SE	63
4.4.2. Pre-operative suspicion of SE	64
4.4.3. Intraoperative diagnosis of SE	64
4.4.4. Treatment of the SE	65
4.4.5. Surgical results	67
References	68
Chapter 5. Surgical Management of Paraesophageal Hernia\r	73
5.1. Introduction	73
5.2. Pathogenesis and Natural History	74
5.3. Symptoms and Diagnosis	75
5.4. Indications for Surgical Therapy	77
5.5. Principles of SurgicalManagement	78
5.5.1. Standard surgical approach	80
References	82
Chapter 6. Failed Anti-Reflux Surgery	85
6.1. Introduction	85
6.2. Types of Anti-reflux Surgery Failure	85
6.3. Anatomic Failure	86
6.4. Functional Failure	87
6.5. Diagnostics of Failed Anti-reflux Surgery	87
6.6. Treatment of Failed Anti-reflux Surgery	88
6.7. Conclusion	89
References	89
Chapter 7. Definition and Significance of Barrett’s Esophagus	91
7.1. History	91
7.2. The Definition of Barrett’s Esophagus (BE)	92
7.3. Significance of the Diagnosis of BE	93
7.3.1. The severity of reflux in BE	93
7.3.2. Relevance of esophagitis	94
7.3.3. Decisions on long-term therapy—medical or surgical	94
7.3.4. Risk of cancer	95
7.3.5. Natural history of BE	95
7.3.6. The question of annual surveillance endoscopy	96
7.3.7. Geographical variations	96
7.4. DiagnosticMethods in BE	97
7.4.1. Standard histology	97
7.4.1.1. Cytosponge	97
7.4.2. Other markers	98
7.5. Immediate Impact of the Diagnosis	98
7.6. Quality of Surveillance Endoscopy	99
References	100
Chapter 8. Endoscopic Therapy for Barrett’s Esophagus: Who and How?	105
8.1. Introduction	105
8.2. Radiofrequency Ablation	106
8.2.1. RFA 360 and RFA 360 express	107
8.2.2. Focal electrode tip Tip-mounted RFA (60, 90)	109
8.2.3. Via the scope platelet electrode “the eagle”	110
8.3. EndoscopicMucosal Resection	110
8.3.1. Endoscopic submucosal dissection	112
8.4. Results After RFA ± EMR	112
8.4.1. Non-dysplastic BE	112
8.4.2. BE and low-grade dysplasia	115
8.4.3. BE and high-grade dysplasia/early cancer	116
8.4.4. Post-RFA medical therapy	117
8.4.5. RFA and anti-reflux surgery	118
8.4.6. Follow-up after RFA	119
8.5. Contraindications for RFA	120
8.6. Cryoablation	120
8.7. Hybrid-Argon Plasma Coagulation	122
8.8. Conclusion	122
References	123
Chapter 9. Current Treatment Strategies in Barrett’s Esophagus	133
9.1. Introduction	133
9.2. PPI Treatment of BE	135
9.3. Barrett’s Esophagus and Anti-reflux Surgery	137
9.4. Treatment after Endoscopic Removal of BE	140
9.5. Conclusion	144
References	144
Chapter 10. Chicago Classification: Impact of HRM on the Diagnosis and Management of Esophageal Motility Disorders	149
10.1. Introduction	149
10.2. Chicago Classification v.3.0	150
10.2.1. Upper esophageal sphincter	152
10.2.2. Esophageal body	152
10.2.2.1. Contraction vigor	152
10.2.2.2. Peristalsis	152
10.2.3. Lower esophageal sphincter	153
10.2.3.1. Esophagogastric morphology	154
10.2.4. Intrabolus pressure pattern	155
10.3. High-ResolutionManometry NamedMotility Disorders According to the Chicago Classification	156
10.4. High-Resolution Manometry and Clinical Utility of Chicago \rClassification: Parameters	159
10.5. Classification of Motility Disorders	163
10.6. Critical Analysis of the Impact of HRM on the Diagnosis of Esophageal Motility Disorders\r	164
10.7. Critical Analysis of the Impact of HRM on theManagement of Esophageal Motility Disorders	165
10.7.1. Achalasia	165
10.7.2. Esophagogastric junction outflow obstruction	166
10.7.3. Major disorders of peristalsis	166
10.7.3.1. Absent contractility	166
10.7.3.2. Distal esophageal spasm	167
10.7.3.3. Hypercontractile esophagus	167
10.7.4. Minor disorders of peristalsis	167
10.7.4.1. Ineffective esophageal motility	167
10.7.4.2. Fragmented peristalsis	168
10.8. Conclusions	168
References	168
Chapter 11. Is There a Role for Endoscopic Therapy in Achalasia?	173
11.1. Introduction	173
11.2. Botulinum Toxin (BoT) Injections	177
11.3. Endoscopic Pneumatic Dilation	179
11.3.1. TheWitzel dilator	180
11.3.2. The rigiflex dilator	181
11.4. Pneumatic Dilatation vs. Laparoscopic HellerMyotomy (LHM)	188
11.5. Other Endoscopic Techniques	190
11.5.1. Esophageal self-expanding metal stents	190
11.5.2. Endoscopic sclerotherapy	191
11.5.3. Peroral endoscopic myotomy (POEM)	191
11.6. Conclusions	191
References	193
Chapter 12. POEM in the Treatment of Primary Esophageal Motility Disorders	201
12.1. Development of POEM	201
12.2. The Technique	201
12.3. Indications and Contraindications	203
12.4. Achalasia	204
12.5. Nutcracker Esophagus	207
12.6. Jackhammer Esophagus	207
12.7. Distal Esophageal Spasm	208
12.8. Other Benign Disorders	208
12.9. Conclusion	208
References	209
Chapter 13. Surgery for Achalasia	215
13.1. Introduction	215
13.2. Length of Myotomy	217
13.3. Significance of Fundoplication	218
13.4. Type of Fundoplication	219
13.5. Surgical Technique and Post-operative Follow-up	221
13.6. Predictors of Outcome and SymptomRecurrence	224
13.7. End-stage Achalasia	228
13.8. New Trends in Surgery for Achalasia: The Future?	229
References	230
Chapter 14. Management of Esophageal Epiphrenic Diverticula	239
14.1. Introduction	239
14.2. Treatment	240
14.3. Surgical Principles	240
14.3.1. Myotomy	240
14.3.2. Fundoplication	241
14.3.3. Diverticulectomy	241
14.3.4. Post-operative treatment	241
14.4. Minimally Invasive Surgery?	242
14.4.1. Techniques	242
14.4.2. Results of treatment	243
14.5. Conclusions	243
References	243
Chapter 15. Minimally InvasiveManagement of Benign Esophageal Tumors and Cysts	245
15.1. Introduction	245
15.2. Leiomyoma	246
15.2.1. Symptoms	246
15.2.2. Diagnosis	247
15.2.3. Treatment	248
15.3. Esophageal Cyst	253
15.3.1. Symptoms and diagnosis	253
15.3.2. Treatment	253
15.4. Conclusions	254
References	254
Chapter 16. Management of Caustic Gastroesophageal Injuries	257
16.1. Introduction	257
16.2. Epidemiology	257
16.3. Corrosive Agents	258
16.4. EmergencyManagement of Caustic Ingestion	258
16.4.1. Pre-hospital management	258
16.4.2. Emergency department management	259
16.4.3. Evaluation of the severity of caustic injuries	259
16.4.3.1. Clinical presentation	259
16.4.3.2. Laboratory studies	260
16.4.3.3. Endoscopy	260
16.4.3.4. Computed tomography	261
16.4.4. Management algorithm	261
16.4.5. Non-operative management	262
16.4.6. Emergency surgery	263
16.4.6.1. Esophagogastrectomy	264
16.4.6.2. Total gastrectomy	265
16.4.6.3. Extended resections	265
16.4.6.4. Tracheobronchial necrosis	266
16.4.7. Outcomes of emergency surgery for caustic ingestion	266
16.5. Delayed Complications of Corrosive Ingestion	266
16.5.1. Upper digestive bleeding	267
16.5.2. Corrosive aspiration pneumonia	267
16.5.3. Fistula formation	267
16.5.4. Caustic strictures	267
16.5.4.1. Gastric strictures	268
16.5.4.2. Esophageal strictures	268
16.5.4.3. Pharyngeal strictures	269
16.5.5. Malignancy	269
16.6. Esophageal Reconstruction	269
16.6.1. Pre-operative evaluation	269
16.6.2. Intraoperative management and operative outcomes	270
16.6.3. Late outcomes of esophageal reconstruction	271
16.7. Conclusion	272
References	272
Chapter 17. ContemporaryManagement of Iatrogenic and Non-iatrogenic Esophageal Injuries	279
17.1. Introduction	279
17.2. ClinicalManifestations	280
17.3. Diagnosis	280
17.3.1. Laboratory findings	280
17.3.2. Cervical and thoracic radiography	280
17.3.3. Contrast esophagogram	281
17.3.4. Computed tomography	281
17.3.5. Upper GI endoscopy	281
17.3.6. Differential diagnosis	281
17.4. Management	281
17.4.1. Non-operative management	282
17.4.2. Endoscopic management	283
17.4.3. Surgical management	283
17.4.3.1. Primary surgical repair	284
17.4.3.2. Diversion	285
17.4.3.3. Esophagectomy	285
17.4.3.4. Drainage only	286
17.5. Outcomes	286
17.6. Traumatic Perforation	287
References	287
Index	291

Surgery For Benign Oesophageal Disorders

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