Laparoscopic management of symptomatic achalasia associated with epiphrenic diverticulum.

Background: We evaluated outcome after laparoscopic esophageal diverticulectomy, myotomy, and partial fundoplication.

Methods: Patients with symptomatic achalasia and epiphrenic diverticula underwent laparoscopic diverticulectomy, Heller myotomy, and partial fundoplication. Intraoperative endoscopy and postoperative esophagography were performed in all patients.

Preoperative intervention does not affect esophageal muscle histology or patient outcomes in patients undergoing laparoscopic Heller myotomy.

Botox injection and pneumatic dilation are common therapies for achalasia. We sought to determine the impact of these preoperative therapies on esophageal muscle histology and outcomes after laparoscopic Heller myotomy. A total of 73 consecutive patients had esophageal muscle biopsies taken from the gastroesophageal junction at the time of myotomy between November 1998 and November 2001.

Transcatheter arterial chemoembolization with or without radiofrequency ablation in the management of patients with advanced hepatic malignancy.

Transcatheter arterial chemoembolization (TACE) is efficacious against hepatic malignancies by rendering tumors ischemic while delivering high-dose chemotherapy. The added benefit of radiofrequency ablation (RFA) has not been determined. We sought to review our experience with TACE with or without RFA in the treatment of hepatocellular carcinoma and colorectal liver metastases in patients not amenable to resection.