Abstract:
:This prospective population-based study was designed to evaluate treatment choices in patients with new manometrically diagnosed achalasia and their outcomes. Patients referred to the esophageal function laboratory were enrolled after a new manometric diagnosis of achalasia. Patients completed an initial achalasia symptom score validated questionnaire on their symptom severity, duration, treatment pre-diagnosis and Medical Outcomes Study 36-item Short-Form (SF-36) survey. Treatment decisions were made by the referring physician and the patient. Follow-up questionnaires were completed every 3 months for 1 year. Patients who chose not to undergo treatment at 1-year follow-up completed another questionnaire after 5 years. Between January 2004 and January 2005, 83 of 124 eligible patients were enrolled. Heller myotomy was performed on 31 patients, three patients received botulinum toxin injections, and 25 patients received 29 pneumatic balloon dilatations. Twenty-four patients chose to receive no treatment. Following treatment, patients treated with surgery, dilatation and botulinum toxin had an average improvement in achalasia symptom score of 23 +/- 12.2, 17 +/- 10.9, and 9 +/- 14, respectively. Patients receiving no treatment had worsening symptoms with a symptom score change of -3.5 +/- 11.4. Surgery and dilatation resulted in significant improvement (P < 0.01) relative to no treatment. In univariate logistic regression, symptom severity score (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.00 to 1.08), sphincter tone (OR 1.04, 95% CI 1.00 to 1.09), difficulty swallowing liquids (OR 3.21, 95% 1.15 to 8.99), waking from sleep (OR 2.75, 95% 1.00 to 7.61), and weight loss (OR 5.99, 95% CI 1.93 to 18.58) were all significant in predicting that patients would select treatment. In the multivariate analysis, older age (OR 1.05, 95% CI 1.01 to 1.09) and weight loss (OR 3.91, 95% CI 1.02 to 15.2) were statistically significant for undergoing treatment. At 5 years, five (21%) of those who had initially declined treatment at 1 year ultimately chose a treatment. Patients who finally chose Heller myotomy had lower mental component dimension scores on the SF-36 at 1 year than those who did not. This study shows that almost one third of patients with manometrically diagnosed achalasia choose not to undergo treatment within 1 year of their diagnosis. Patients who are more symptomatic appear to be more likely to undergo treatment by univariate analysis. In multivariate analysis, increasing age and weight loss are predictive of those who will undergo treatment, with weight loss having the greatest influence. Patients who choose not to undergo treatment make lifestyle changes to maintain their quality of life, and only a minority of them ultimately undergo treatment.
journal_name
Dis Esophagusjournal_title
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagusauthors
Yeung JC,Finley C,Hanna WC,Miller L,Ferri L,Urbach DR,Darling GEdoi
10.1111/dote.12348subject
Has Abstractpub_date
2016-07-01 00:00:00pages
472-8issue
5eissn
1120-8694issn
1442-2050journal_volume
29pub_type
杂志文章abstract::Barrett's esophagus (BE) is a chronic complication associated with gastroesophageal reflux disease. The ICD-9-CM code used for BE, 530.2, is also used for patients with 'ulcer of the esophagus.' We aimed to determine if the ICD-9-CM code of 530.2 is reliable for identifying cases of Barrett's esophagus within database...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1442-2050.2007.00800.x
更新日期:2008-01-01 00:00:00
abstract::Esophageal cancer stenting offers symptomatic relief for patients suffering from dysphagia. There are limited data to support their use to relieve dysphagia and improve nutrition during neoadjuvant therapy with some concern that they may negatively impact oncological outcomes. The aim of this systematic review was to ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doz090
更新日期:2020-01-16 00:00:00
abstract::The high-resolution microendoscope (HRME) is a novel imaging modality that may be useful in the surveillance of Barrett's esophagus in low-resource or community-based settings. In order to assess accuracy and interrater reliability of microendoscopists in identifying Barrett's-associated neoplasia using HRME images, w...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12040
更新日期:2014-01-01 00:00:00
abstract::The progression of certain primary esophageal motor disorders to achalasia has been documented; however, the true incidence of this decay is still elusive. This study aims to evaluate: (i) the incidence of the progression of diffuse esophageal spasm to achalasia, and (ii) predictive factors to this progression. Thirty...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2012.01377.x
更新日期:2013-07-01 00:00:00
abstract::Increasing experience with transhiatal esophagectomy (THE) has brought with it a good understanding of the advantages and disadvantages of the technique. As in our case, diaphragmatic hernias after THE may result from excess manipulation and extension of the hiatus during surgery. The varying nature of the clinical pr...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.2002.00233.x
更新日期:2002-01-01 00:00:00
abstract::The present study evaluates the role of oesophageal manometry in clinical practice. Over 5 years, 347 consecutive patients were evaluated in our oesophageal laboratory. The reasons for referral were: dysphagia (11.5%), gastro-oesophageal reflux disease (GORD) (46.7%), non-cardiac chest pain (28.5%), connective tissue ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.1999.00013.x
更新日期:1999-01-01 00:00:00
abstract::Unconsciously caustic ingestion is one of the most common causes of serious esophageal strictures in children. The aim of this study is to determine the efficiency of polaprezinc in preventing stricture formation after corrosive esophageal burns (CEB); this was the first time it has been used to treat experimental CEB...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/dox104
更新日期:2017-11-01 00:00:00
abstract::Gastroesophageal reflux disease (GERD) is a common disorder of the upper gastrointestinal tract which is typically characterized by heartburn and acid regurgitation. These symptoms are widespread in the community and range from 2.5% to more than 25%. Economic analyses showed an increase in direct and indirect costs re...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1111/dote.12511
更新日期:2017-02-01 00:00:00
abstract::Stapled esophagogastric anastomosis after esophagectomy is considered to be superior to traditional handsewn techniques. Linear staplers are usually used. The aim of this study is to evaluate early postoperative results of circular stapler in cervical esophagogastric anastomosis. Records of all patients who underwent ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2008.00913.x
更新日期:2009-01-01 00:00:00
abstract::Hiatal hernia is an underlying factor contributing to gastroesophageal reflux disease (GERD). However, it remains elusive whether the size of the esophageal hiatus has a de facto influence on the lower esophageal sphincter (LES), on the intensity of patient reflux, on GERD symptoms and on the quality of life (QoL). On...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2011.01238.x
更新日期:2012-04-01 00:00:00
abstract::Barrett's esophagus, the management of which remains controversial, is the precursor condition to esophageal adenocarcinoma. A number of endoscopic treatments have been designed as an alternative to surgical resection for patients with high-grade dysplasia. One of these, photodynamic therapy, involves the light activa...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1111/j.1442-2050.2010.01078.x
更新日期:2010-11-01 00:00:00
abstract::Two achalasia patients with former complaints of heartburn were examined. Antisecretory drugs were used by the patients when dysphagia occurred. Barium X-ray and esophageal manometry were performed and achalasia was diagnosed in both patients. Twenty-four-hour pH-metry showed significant and long-lasting acid reflux d...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2005.00515.x
更新日期:2005-01-01 00:00:00
abstract::Eosinophilic esophagitis (EoE) is an esophageal allergic inflammatory disorder often presenting with infant/toddler gastroesophageal reflux symptoms refractory to treatment, including acid suppression trials with histamine H2 antagonists and proton pump inhibitors. We propose to evaluate the impact of infant acid supp...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doaa073
更新日期:2020-10-12 00:00:00
abstract::Esophageal adenocarcinoma (EAC) has had the fastest increasing incidence of any solid tumor in the United States in the last 30 years. Long standing gastroesophageal reflux disease is a well-established risk factor with strong associations with obesity, alcohol and tobacco. However, there are likely additional contrib...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doaa036
更新日期:2020-12-07 00:00:00
abstract:OBJECTIVE:Patient-reported outcome (PRO) measures are commonly used to capture patient experience with dysphagia and to evaluate treatment effectiveness. Inappropriate application can lead to distorted results in clinical studies. A systematic review of the literature on dysphagia-related PRO measures was performed to ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1093/dote/dow028
更新日期:2017-05-01 00:00:00
abstract::Esophageal squamous cell carcinoma (ESCC) is one of the most frequently diagnosed cancers in China, but the etiology and mode of carcinogenesis of this disease remain poorly understood. Phosphatase and tensin homolog deleted on chromosome 10 (PTEN), as a negative regulator of Akt/mTOR pathway, frequently mutates or is...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12448
更新日期:2017-02-01 00:00:00
abstract::Fas (CD95/Apo-1) receptor (FasR) is a cell-surface receptor that mediates apoptotic cell death upon triggering by Fas ligand (FasL). We sought to determine whether normal human esophageal epithelial cells express FasL and/or FasR and whether their localization is consistent with a role in the turnover of normal esopha...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.1999.00032.x
更新日期:1999-01-01 00:00:00
abstract::Local failure after definitive chemoradiotherapy (CRT) for stage IB, II, and III esophageal cancer is one of the causes of poor outcome. Endoscopic mucosal resection (EMR) is an effective treatment for superficial esophageal cancer. However, its feasibility as a salvage treatment for local recurrent or residual tumors...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12037
更新日期:2014-01-01 00:00:00
abstract::The incidence of esophageal cancer has risen dramatically in the Western world. Although surgical resection of esophageal tumors is considered the cornerstone of curative approaches in localized esophageal cancer, approximately 40% of patients who undergo chemoradiation followed by surgery will experience a recurrence...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1111/dote.12506
更新日期:2017-02-01 00:00:00
abstract::Perforations of the esophagus are uncommon complications of flexible gastrointestinal endoscopy. Perforations after endoscopy are likely to occur in the cervical esophagus, where fiber insertion is difficult anatomically. The diagnosis should be made as soon as possible, because mediastinitis and sepsis frequently dev...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.2002.00253.x
更新日期:2002-01-01 00:00:00
abstract::Progressive dysphagia of unknown etiology may still provide a diagnostic challenge despite an increase in the number and quality of investigations available. We describe a 64-year-old man who presented with progressive dysphagia and weight loss. Following a number of investigations, a diagnosis of diffuse esophageal l...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2010.01114.x
更新日期:2011-04-01 00:00:00
abstract::Neoadjuvant chemotherapy may improve the outcome of esophageal cancer after esophagectomy, but is accompanied by considerable toxicity by collateral destruction of normal cells. Such side effects may be avoided by developing therapies that specifically target molecular characteristics of tumors. The aim of the present...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2009.00951.x
更新日期:2009-01-01 00:00:00
abstract::Biological plausibility and evidence from case series indicate that an increased body mass index could be a risk factor for Barrett's esophagus. The aim of this study was to assemble and appraise the available evidence on the association of body mass index and Barrett's esophagus in a narrative approach. A systematic ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1111/j.1442-2050.2009.00967.x
更新日期:2009-01-01 00:00:00
abstract::The impact of body weight on outcomes after robotic-assisted esophageal surgery for cancer has not been studied. We examined the short-term operative outcomes in patients according to their body mass index following robotic-assisted Ivor-Lewis esophagectomy at a high-volume tertiary-care referral cancer center and eva...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12484
更新日期:2017-01-01 00:00:00
abstract::The survival advantage associated with the addition of surgical therapy in esophageal squamous cell carcinoma (ESCC) patients who demonstrate a complete clinical response to chemoradiotherapy is unclear, and many institutions have adopted an organ-preserving strategy of selective surgery in this population. We sought ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doz067
更新日期:2020-03-16 00:00:00
abstract::The development of an adenocarcinoma in a reconstructed tube after subtotal esophagectomy for esophagus squamous cell carcinoma (ESCC) is uncommon and has been reported in articles from the Japanese medical community. We report three cases of patients who had this clinical presentation. We suggest an approach to posto...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.2003.00317.x
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:The COVID-19 pandemic continues to have a significant impact on the provision of medical care. Planning to ensure there is capability to treat those that become ill with the virus has led to an almost complete moratorium on elective work. This study evaluates the impact of COVID-19 on cancer, in particular s...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doaa091
更新日期:2020-09-04 00:00:00
abstract::Heller's esophagomyotomy relieves dysphagia but does not restore esophageal peristalsis. The myotomy may induce reflux and the addition of a 360 degrees fundoplication may be hazardous with regard to the remaining aperistaltic esophagus. The aim of this prospectively randomized clinical trial was to compare the outcom...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1442-2050.2003.00348.x
更新日期:2003-01-01 00:00:00
abstract::The effect of endoscopic submucosal dissection (ESD) on esophageal motility remains unknown. Therefore, the aim of this study is to elucidate changes in esophageal motility after ESD along with the cause of dysphagia using high-resolution manometry (HRM). This is a before-and-after trial of the effect of ESD on the es...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/dox057
更新日期:2017-11-01 00:00:00
abstract::Barrett's esophagus (BE) is the strongest risk factor for the development of esophageal adenocarcinoma. However, the risk of cancer progression is difficult to ascertain in individuals, as a significant number of patients with BE do not necessarily progress to esophageal adenocarcinoma. There are several issues with t...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1111/dote.12015
更新日期:2013-08-01 00:00:00