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  • 1
    Online Resource
    Online Resource
    Chevalier Jackson: father of endoscopic surgery, and champion of women in medicine, social justice, and public health
    Springer Science and Business Media LLC ; 2023
    In:  Surgical Endoscopy Vol. 37, No. 9 ( 2023-09), p. 6660-6671
    Details
    In: Surgical Endoscopy, Springer Science and Business Media LLC, Vol. 37, No. 9 ( 2023-09), p. 6660-6671
    Abstract: Chevalier Jackson (1865–1958) was a pioneering force in the medical world, whose extraordinary contributions to surgery and public health have left an indelible impact. He developed the endoscope and perfected the bronchoscope, and his mastery of these tools enabled him to transform the prognosis of foreign body aspiration from 98% mortality to 98% survival. He was also a passionate advocate of public health chairing the national committee on lye legislation, which culminated in the Caustic Poison Act, responsible for poison and antidote labels. Yet Jackson’s accomplishments were not limited to these. The aim of this manuscript was to shed light on Chevalier Jackson’s lesser-known contributions to surgical science and culture, and to celebrate and honor the life of this remarkable surgeon. Methods Digital and physical historical records from the National Library of Medicine, Smithsonian Institution, Heinz History Center in Pittsburgh PA, and Sunrise Mill Museum, Montgomery County PA were reviewed for Chevalier Jackson’s scientific, cultural, and social contributions to the field of surgery. Results Among his lesser-known contributions, Chevalier Jackson was the first to describe erosive esophagitis. He developed the first standardized tracheotomy procedure, still in use today. He was ahead of his time in many ways, pioneering a multidisciplinary approach to medicine, advocating for patient-centered care, and advancing the inclusion of women in the medical profession. Conclusion Chevalier Jackson’s legacy extends far beyond the tools and techniques he invented. He was a champion of social justice, a protector of patients, and an inspiration to medical professionals across the globe.
    Type of Medium: Online Resource
    ISSN: 0930-2794 , 1432-2218
    URL: Article
    DOI: 10.1007/s00464-023-10256-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1463171-4
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  • 2
    Online Resource
    Online Resource
    The impact of delayed gastric emptying as measured by gastric emptying scintigraphy on the outcome of magnetic sphincter augmentation
    Springer Science and Business Media LLC ; 2023
    In:  Surgical Endoscopy Vol. 37, No. 9 ( 2023-09), p. 7144-7152
    Details
    In: Surgical Endoscopy, Springer Science and Business Media LLC, Vol. 37, No. 9 ( 2023-09), p. 7144-7152
    Abstract: The impact of delayed gastric emptying (DGE) on the outcome of anti-reflux surgery (ARS) is controversial. There is concern that poor gastric emptying diminishes outcomes. Magnetic sphincter augmentation (MSA) may have a comparatively mild impact on gastric physiology, but the relationship between DGE and MSA outcomes is unknown. This study aims to evaluate the relationship between objective DGE and MSA outcomes over time. Methods Patients who completed gastric emptying scintigraphy (GES) prior to MSA between 2013 and 2021 were included. DGE was defined as a 4 h retention  〉  10% or half emptying time  〉  90 min on GES. Outcomes were compared between DGE and normal gastric emptying (NGE) groups at 6 months, 1 and 2 years. Sub-analysis of patients with severe ( 〉  35%) DGE and correlation analysis between 4-h retention and symptom and acid-normalization were performed. Results The study population consisted of 26 (19.8%) patients with DGE and 105 with NGE. DGE was associated with more 90-days readmissions (18.5 vs 2.9%, p  = 0.009). At 6 months patients with DGE had higher median (IQR) GERD-HRQL total [17.0(10–29) vs 5.5(3–16), p  = 0.0013], heartburn [1(1–3) vs 0(0–1), p  = 0.0010) and gas-bloat [4(2–5) vs 2(1–3), p  = 0.033] scores. Outcomes at 1 and 2 years follow-up were comparable ( p   〉  0.05). From 6 months to 1-year the gas-bloat score decreased from 4(2–5 ) to 3(1–3), p  = 0.041. Total and heartburn scores decreased, but not significantly. Severe DGE ( n  = 4) patients had lower antiacid medication freedom at 6 months (75 vs 87%, p  = 0.014) and 1-year (50 vs 92%, p  = 0.046). There were non-significant trends for higher GERD-HRQL scores, dissatisfaction, and removal rates in severe DGE at 6 months and 1-year. There was a weak correlation between 4-h retention and 6-month GERD-HRQL total score [ R  = 0.253, 95%CI (0.09–0.41), p  = 0.039], but not acid-normalization ( p   〉  0.05). Conclusion Outcomes after MSA are diminished early on in patients with mild-to-moderate DGE, but comparable by 1 year and durable at 2 years. Severe DGE outcomes may be suboptimal. Graphical abstract
    Type of Medium: Online Resource
    ISSN: 0930-2794 , 1432-2218
    URL: Article
    DOI: 10.1007/s00464-023-10190-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1463171-4
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  • 3
    Online Resource
    Online Resource
    Acute superior mesenteric artery syndrome with complete foregut obstruction following Nissen fundoplication
    Elsevier BV ; 2023
    In:  International Journal of Surgery Case Reports Vol. 104 ( 2023-03), p. 107958-
    Details
    In: International Journal of Surgery Case Reports, Elsevier BV, Vol. 104 ( 2023-03), p. 107958-
    Type of Medium: Online Resource
    ISSN: 2210-2612
    URL: Article
    DOI: 10.1016/j.ijscr.2023.107958
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2558001-2
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  • 4
    Online Resource
    Online Resource
    GERD after Peroral Endoscopic Myotomy: Assessment of Incidence and Predisposing Factors
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Journal of the American College of Surgeons Vol. 236, No. 1 ( 2023-01), p. 58-70
    Details
    In: Journal of the American College of Surgeons, Ovid Technologies (Wolters Kluwer Health), Vol. 236, No. 1 ( 2023-01), p. 58-70
    Abstract: Peroral endoscopic myotomy (POEM) is an effective intervention for achalasia, but GERD is a major postoperative adverse event. This study aimed to characterize post-POEM GERD and identify preoperative or technical factors impacting development or severity of GERD. STUDY DESIGN: This is a retrospective review of patients who underwent POEM at our institution. Favorable outcome was defined as postoperative Eckardt score of 3 or less. Subjective GERD was defined as symptoms consistent with reflux. Objective GERD was based on a DeMeester score greater than 14.7 or Los Angeles grade C or D esophagitis. Severe GERD was defined as a DeMeester score greater than 50.0 or Los Angeles grade D esophagitis Preoperative clinical and objective data and technical surgical elements were compared between those with and without GERD. Multivariate logistic analysis was performed to identify factors associated with each GERD definition. RESULTS: A total of 183 patients underwent POEM. At a mean ± SD follow-up of 21.7 ± 20.7 months, 93.4% achieved favorable outcome. Subjective, objective, and severe objective GERD were found in 38.8%, 50.5%, and 19.2% of patients, respectively. Of those with objective GERD, 24.0% had no reflux symptoms. Women were more likely to report GERD symptoms (p = 0.007), but objective GERD rates were similar between sexes (p = 0.606). The independent predictors for objective GERD were normal preoperative diameter of esophagus (odds ratio [OR] 3.4; p = 0.008) and lower esophageal sphincter (LES) pressure less than 45 mmHg (OR 1.86; p = 0.027). The independent predictors for severe objective GERD were LES pressure less than 45 mmHg (OR 6.57; p = 0.007) and obesity (OR 5.03; p = 0.005). The length of esophageal or gastric myotomy or indication of procedure had no impact on the incidence or severity of GERD. CONCLUSION: The rate of pathologic GERD after POEM is higher than symptomatic GERD. A nonhypertensive preoperative LES is a predictor for post-POEM GERD. No modifiable factors impact GERD after POEM.
    Type of Medium: Online Resource
    ISSN: 1072-7515
    URL: Article
    DOI: 10.1097/XCS.0000000000000448
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 5
    Online Resource
    Online Resource
    Impact of Objective Colonic and Whole Gut Motility Data as Measured by Wireless Motility Capsule on Outcomes of Antireflux Surgery
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Journal of the American College of Surgeons Vol. 236, No. 2 ( 2023-02), p. 305-315
    Details
    In: Journal of the American College of Surgeons, Ovid Technologies (Wolters Kluwer Health), Vol. 236, No. 2 ( 2023-02), p. 305-315
    Abstract: Studies show higher rates of dissatisfaction with antireflux surgery (ARS) outcomes in patients with chronic constipation. This suggests a relationship between colonic dysmotility and suboptimal surgical outcome. However, due to limitations in technology, there is no objective data available examining this relationship. The wireless motility capsule (WMC) is a novel technology consisting of an ingestible capsule equipped with pH, temperature, and pressure sensors, which provide information regarding regional and whole gut transit times, pH and motility. The aim of this study was to assess the impact of objective regional and whole gut motility data on the outcomes of ARS. STUDY DESIGN: This was a retrospective review of patients who underwent WMC testing before ARS. Transit times, motility, and pH data obtained from different gastrointestinal tract regions were used in analysis to determine factors that impact surgical outcome. A favorable outcome was defined as complete resolution of the predominant reflux symptom and freedom from antisecretory medications. RESULTS: The final study population consisted of 48 patients (fundoplication [n = 29] and magnetic sphincter augmentation [n = 19] ). Of those patients, 87.5% were females and the mean age ± SD was 51.8 ± 14.5 years. At follow-up (mean ± SD, 16.8 ± 13.2 months), 87.5% of all patients achieved favorable outcomes. Patients with unfavorable outcomes had longer mean whole gut transit times (92.0 hours vs 55.7 hours; p = 0.024) and colonic transit times (78.6 hours vs 47.3 hours; p = 0.028), higher mean peak colonic pH (8.8 vs 8.15; p = 0.009), and higher mean antral motility indexes (310 vs 90.1; p = 0.050). CONCLUSIONs: This is the first study to demonstrate that objective colonic dysmotility leads to suboptimal outcomes after ARS. WMC testing can assist with preoperative risk assessment and counseling for patients seeking ARS.
    Type of Medium: Online Resource
    ISSN: 1072-7515
    URL: Article
    DOI: 10.1097/XCS.0000000000000470
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 6
    Online Resource
    Online Resource
    1209 INCREASED ACCUMULATION OF SORBITOL IN EMBRYOS OF MANIFEST DIABETIC RATS
    Springer Science and Business Media LLC ; 1985
    In:  Pediatric Research Vol. 19, No. 4 ( 1985-4), p. 312A-312A
    Details
    In: Pediatric Research, Springer Science and Business Media LLC, Vol. 19, No. 4 ( 1985-4), p. 312A-312A
    Type of Medium: Online Resource
    ISSN: 0031-3998 , 1530-0447
    URL: Article
    DOI: 10.1203/00006450-198504000-01239
    Language: Unknown
    Publisher: Springer Science and Business Media LLC
    Publication Date: 1985
    detail.hit.zdb_id: 2031217-9
    SSG: 12
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  • 7
    Online Resource
    Online Resource
    Sorbitol metabolism in retina studied in vitro
    Springer Science and Business Media LLC ; 1989
    In:  Graefe's Archive for Clinical and Experimental Ophthalmology Vol. 227, No. 2 ( 1989-3), p. 180-183
    Details
    In: Graefe's Archive for Clinical and Experimental Ophthalmology, Springer Science and Business Media LLC, Vol. 227, No. 2 ( 1989-3), p. 180-183
    Type of Medium: Online Resource
    ISSN: 0721-832X , 1435-702X
    URL: Article
    DOI: 10.1007/BF02169793
    RVK:
    XA 10000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 1989
    detail.hit.zdb_id: 1459159-5
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  • 8
    Online Resource
    Online Resource
    Long-term clinical and functional results of magnetic sphincter augmentation
    Oxford University Press (OUP) ; 2023
    In:  Diseases of the Esophagus Vol. 36, No. Supplement_1 ( 2023-06-15)
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 36, No. Supplement_1 ( 2023-06-15)
    Abstract: Magnetic sphincter augmentation (MSA) was introduced in 2007 as an alternative surgical procedure for patients with gastroesophageal reflux disease (GERD). The majority of data since MSA’s introduction has focused on short and intermediate-term results, demonstrating safety and high efficacy in terms of reflux symptom control, freedom from proton pump inhibitor use and normalization of distal esophageal acid exposure. However, GERD is a chronic condition that demands a long-term solution. Limited available data from studies reporting outcomes at 5 years or later following MSA demonstrate that the promising short- and mid-term efficacy and safety profile of MSA remains relatively constant in the long term. Compared with Nissen fundoplication, MSA has a much lower rate of gas-bloat and inability to belch at a short-term follow-up, a difference that persists in the long-term. The most common complaint after MSA at a short-term follow-up is dysphagia. However, limited data suggest dysphagia rates largely decrease by 5 years. Dysphagia is the most common indication for dilation and device removal in both early- and long-term studies. However, the overall rates of dilation and removal are similar in short- and long-term reports, suggesting the majority of these procedures are performed in the short-term period after device implantation. The indications and standard practices of MSA have evolved over time. Long-term outcome data currently available are all from patient cohorts who were selected for MSA under early restricted indications and outdated regimens. Therefore, further long-term studies are needed to corroborate the preliminary, yet encouraging long-term results.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doac109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2004949-3
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  • 9
    Online Resource
    Online Resource
    Magnetic sphincter augmentation and high-resolution manometry: impact of biomechanical properties on esophageal motility and clinical significance for selection and outcomes
    Oxford University Press (OUP) ; 2023
    In:  Diseases of the Esophagus Vol. 36, No. Supplement_1 ( 2023-06-15)
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 36, No. Supplement_1 ( 2023-06-15)
    Abstract: Magnetic sphincter augmentation (MSA)was introduced as an alternative to laparoscopic Nissen fundoplication (LNF). This reproducible, outpatient procedure addresses the etiology of gastroesophageal reflux disease by implanting a ring of magnetic beads across the esophagogastric junction (EGJ). MSA is designed to resist effacement of the lower esophageal sphincter (LES) and, similar to LNF, results in restoration of anti-reflux barrier competency by increasing overall length, intraabdominal length and resting pressure of the sphincter. However, the novel use of magnets to augment the physiology of the LES poses unique challenges to the physiology of the EGJ and esophagus. These impacts are best revealed through manometry. The degree of restrictive forces at the EGJ, as measured by intrabolus pressure and integrated relaxation pressure, is higher after MSA compared with LNF. In addition, contrary to the LNF, which retains neurohormonal relaxation capability during deglutition, the magnetic forces remain constant until forcibly opened. Therefore, the burden of overcoming EJG resistance is placed solely on the esophageal body contractile force, as measured by distal contractile integral and distal esophageal amplitude. The main utility of preoperative manometry is in determining whether a patient’s esophagus has sufficient contractility or peristaltic reserve to adapt to the challenge of an MSA. Manometric thresholds predictive of MSA outcomes deviate from those used to define named Chicago Classification motility disorders. Therefore, individual preoperative manometric characteristics should be analyzed to aid in risk stratification and patient selection prior to MSA.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doac092
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2004949-3
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  • 10
    Online Resource
    Online Resource
    Ineffective esophageal motility: The impact of change of criteria in Chicago Classification version 4.0 on predicting outcome after magnetic sphincter augmentation
    Wiley ; 2023
    In:  Neurogastroenterology & Motility Vol. 35, No. 9 ( 2023-09)
    Details
    In: Neurogastroenterology & Motility, Wiley, Vol. 35, No. 9 ( 2023-09)
    Abstract: The most recent update of the Chicago Classification (CCv4.0) attempts to provide a more clinically relevant definition for ineffective esophageal motility (IEM). The impact of this new definition on predicting outcome after antireflux surgery is unknown. The aim of this study was to compare utility of IEM diagnosis based on CCv4.0 to CCv3.0 in predicting surgical outcome after magnetic sphincter augmentation (MSA) and to assess any additional parameters that hold value in future definitions. Methods Records of 336 patients who underwent MSA at our institution between 2013 and 2020 were reviewed. Preoperative manometry files were re‐analyzed using both Chicago Classification version 3.0 (CCv3.0) and CCv4.0 definitions of IEM. The utility of each IEM definition in predicting surgical outcome was then compared. Individual manometric components and impedance data were also assessed. Key Results Immediate dysphagia was reported by 186 (55.4%) and persistent dysphagia by 42 (12.5%) patients. CCv3.0 IEM criteria were met by 37 (11%) and CCv4.0 IEM by 18 (5.4%) patients ( p  = 0.011). CCv3.0 and CCv4.0 IEM were equally poor predictors of immediate (AUC = 0.503 vs. 0.512, p  = 0.7482) and persistent (AUC = 0.519 vs. 0.510, p  = 0.7544) dysphagia. The predicted dysphagia probability of less than 70% bolus clearance (BC) was 17.4%, higher than CCv4.0 IEM at 16.7%. When BC was incorporated into CCv4.0 IEM criteria, the probability increased significantly to 30.0% ( p  = 0.0042). Conclusions & Inferences The CCv3.0 and CCv4.0 of IEM are poor predictors of dysphagia after MSA. Adding BC to the new definition improves its predictive utility and should be considered in future definitions.
    Type of Medium: Online Resource
    ISSN: 1350-1925 , 1365-2982
    URL: Issue
    URL: Article
    DOI: 10.1111/nmo.v35.9
    DOI: 10.1111/nmo.14624
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2008278-2
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