The purpose of this publication is to identify the prevalence of arrhythmia as one of the manifestations of gastrocardial syndrome in patients with hernias of the esophageal orifice of the diaphragm and reflux esophagitis. To evaluate the results of antireflux surgery in the dynamics of arrhythmia regression. Materials and methods: the study included 101 patients with hiatal hernias who were undergoing inpatient examination and treatment. Arrhythmia was detected in 35 (34.6%) of 101 patients with hernias of the esophageal orifice of the diaphragm. Arrhythmias are characteristic of cardiofundal (40%), subtotal (66.6%) and total (100.0%) hernias of the esophageal orifice of the diaphragm, were recorded at a younger age, were dependent on the duration of the underlying disease. Clinical manifestations of arrhythmia depended on the degree of shortening of the esophagus, most often arrhythmias occurred with shortening of the esophagus of the II degree in cardiofundal hernias (68.7%), subtotal (60.0%) and total (100.0%). As a result of antireflux surgery, clinical manifestations of arrhythmia regressed in 19 (54.3%), in 26 (74.2%) patients, electrocardiogram and Holter monitoring indicators decreased or were absent altogether. In conclusion, it should be emphasized that arrhythmias on the background of hernia of the esophageal orifice of the diaphragm, associated with anatomotopographic and physiological features, are a frequent clinical situation characterized by the mutually aggravating effect of both diseases on each other. An instrumental study of the state of the cardiovascular system in the pathology of the upper gastrointestinal tract showed that there is an improvement in the indicators of cardiac arrhythmias associated with the underlying disease, the correction of which is possible only with surgical treatment of the underlying disease.
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J Clin Gastroenterol
February 2025
Digestive Disease and Surgery Institute, Cleveland Clinic London, UK.
Peroral endoscopic myotomy (POEM) is a novel technique within the field of third space endoscopy. The overarching principal is creation of a mucosal incision, careful dissection of the submucosal space using an electrosurgical knife to reach the muscularis (ie, tunneling), performing a controlled myotomy, and finally, closure of the mucosal incision. POEM was first developed for the management of achalasia, and now a decade of evidence shows the procedure is safe, effective, and highly reproducible.
View Article and Find Full Text PDFGastrointest Endosc
December 2024
Department of Gastroenterology and Hepatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China. Electronic address:
Dis Esophagus
January 2025
Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Gastroesophageal reflux disease (GERD) after peroral endoscopic myotomy (POEM) has been a limiting factor with POEM. Sling-fiber preservation during POEM was reported to reduce postoperative GERD in Japan. This study investigates the efficacy of this technique in a western population.
View Article and Find Full Text PDFEsophagus
January 2025
Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Background: An "esophageal rosette" (ER) sign is one of the endoscopic findings in primary esophageal achalasia. We investigated whether ER was associated with the therapeutic efficacy of peroral endoscopic myotomy (POEM).
Methods: The clinical characteristics and short-term outcomes of POEM were retrospectively evaluated in 69 patients who underwent the procedure for esophageal achalasia.
Rev Esp Enferm Dig
November 2024
Gastroenterology, Gaochun People's Hospital of Nanjing, China.
A 67-year-old male was admitted to our hospital with a diagnose of a <1-cm clear dehiscence orifice at the gastroesophageal anastomosis. Considering of the cachexia state and the size of fistula, a new endoscopic clipping therapy, called mucosal incision-assisted closure with clips, was performed. The procedure as follows: First, used electrotome to puncture and destroy the epithelium of the fistula mouth.
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