| An improved method of assessing esophageal emptying using the timed barium study following surgical myotomy for achalasia. | |
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MedLine Citation:
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PMID: 18949523 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: The timed barium study (TBS) is used to assess esophageal emptying in patients with achalasia. Improvement in emptying correlates with outcome after endoscopic therapy, but the results of the TBS have been variable after myotomy. Our aim was to evaluate a new method for assessing improvement in emptying after myotomy. METHODS: A TBS was performed before and 3-6 months after myotomy in 30 patients. Emptying was assessed by measuring the percent difference in area of the barium column on films obtained 1 and 5 min after ingesting 150 ml of barium. Initial esophageal clearance was also assessed by comparing the area of the barium column on 1-min images obtained before and after therapy. Both measures were compared to clinical outcome. RESULTS: After myotomy, 21 patients (70%) had no symptoms, four (13%) had mild, and five (17%) had moderate/severe symptoms. Using the standard method, esophageal emptying before and after surgery were not significantly different (25% vs. 37%; p = 0.22) and did not correlate with clinical outcome. In contrast, initial esophageal clearance improved significantly (median 81%) and correlated with clinical outcome. CONCLUSION: Esophageal emptying measured by the standard method is not useful to assess outcome after myotomy. However, initial esophageal clearance correlates well with clinical outcome. |
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Authors:
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Arzu Oezcelik; Jeffrey A Hagen; James M Halls; Jessica M Leers; Emmanuele Abate; Shahin Ayazi; Joerg Zehetner; Steven R DeMeester; Farzaneh Banki; John C Lipham; Tom R DeMeester |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-10-24 |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: 13 ISSN: 1873-4626 ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2008-12-19 Completed Date: 2009-04-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: United States |
Other Details:
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Languages: eng Pagination: 14-8 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Southern California, Keck School of Medicine, 1510 San Pablo Street, Los Angeles, CA 90033, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Barium Sulfate / administration & dosage, diagnostic use* Contrast Media / administration & dosage Esophageal Achalasia / physiopathology, radiography, surgery* Esophagus / physiopathology*, radiography, surgery Female Fluoroscopy / methods* Follow-Up Studies Gastrointestinal Motility / physiology* Humans Laparoscopy / methods* Male Manometry Middle Aged Postoperative Period Pressure Retrospective Studies Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 7727-43-7/Barium Sulfate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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