Mikol Petrossian

23 statements · 1 topic

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▶ Ep 4 · 0:27
In all cases of achalasia, the lower esophageal sphincter fails to relax at the right time.
quote · Achalasia
▶ Ep 4 · 2:25
Type two is the most common, but responds also the best to surgery.
quote · Achalasia

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Mikol's statements about Achalasia 23 statements

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Update Course Rewind: Updates in Achalasia 2023

▶ Ep 4 · 0:27
clinical In all cases of achalasia, the lower esophageal sphincter fails to relax at the right time, but depending on the rest of the esophageal movements, there are three types of achalasia. ↗
▶ Ep 4 · 0:27
quote In all cases of achalasia, the lower esophageal sphincter fails to relax at the right time. ↗
▶ Ep 4 · 1:30
clinical In type one achalasia, the esophagus barely contracts, so food moves down because of gravity alone. ↗
▶ Ep 4 · 1:40
clinical In type two achalasia, pressure builds up in the esophagus, causing it to become compressed. ↗
▶ Ep 4 · 1:50
clinical In type three achalasia, there are abnormal contractions on the bottom of the esophagus where it meets the stomach. ↗
▶ Ep 4 · 2:00
clinical Type three achalasia does not respond well to treatments, and recurrences happen much more in patients with type three achalasia. ↗
▶ Ep 4 · 2:00
quote Type three does not respond well to treatments. ↗
▶ Ep 4 · 2:15
clinical All three types of achalasia respond to myotomy of the lower esophageal sphincter, but the outcomes are a little different. ↗
▶ Ep 4 · 2:25
clinical Type two achalasia is the most common and responds the best to surgery. ↗
▶ Ep 4 · 2:25
quote Type two is the most common, but responds also the best to surgery. ↗
▶ Ep 4 · 2:32
clinical The Eckardt score is the grading system most frequently used for the evaluation of symptoms, status, and efficacy of achalasia treatment, consisting of weight loss, dysphagia, chest pains, and regurgitation. ↗
▶ Ep 4 · 3:10
opinion Laparoscopic Heller myotomy is probably the gold standard procedure as of today. ↗
▶ Ep 4 · 3:30
quote We currently don't do, uh, fundoplication. We do not offer any wrap. ↗
▶ Ep 4 · 3:40
clinical In the adult literature, if a Heller is done, there's a fair amount of good literature showing that you don't need to do a fundoplication. ↗
▶ Ep 4 · 3:52
epidemiological In the current population of pediatric patients who had POEM and were biopsied a year out, the rate of reflux is about 5%, compared to around 50% in adults. ↗
▶ Ep 4 · 3:52
quote The rate, rate, rate of reflux is about 5%. If you compare it to adults, it's around 50%. ↗
▶ Ep 4 · 5:52
clinical An incomplete myotomy is basically not going far enough down during the initial surgery. ↗
▶ Ep 4 · 6:05
clinical Recurrent achalasia is categorized as related to growth, such as when a young child who had surgery grows significantly. ↗
▶ Ep 4 · 6:18
clinical If a child has symptoms within a year of surgery, it is likely an incomplete myotomy. ↗
▶ Ep 4 · 6:18
quote If you have a symptoms in a child within a year, I think it's an incomplete myotomy. ↗
▶ Ep 4 · 6:50
clinical Recurrent achalasia means the patient had achalasia, resolved symptoms after surgery, and due to growth presents with symptoms again after a long period of time, meaning more than one year. ↗
▶ Ep 4 · 7:05
clinical An incomplete myotomy is a patient that never fully resolved symptoms or did so for only a short period of time after surgery. ↗
▶ Ep 4 · 7:17
clinical For patients with prior achalasia surgery presenting with symptoms, investigation should include manometry, EGD, and biopsy to determine if the issue is a wrap problem, incomplete myotomy, or recurrent achalasia. ↗