Functional lumen imaging probe to assess geometric changes in the esophagogastric junction following endolumenal fundoplication

BACKGROUND: The functional lumen imaging probe (FLIP) uses impedance planimetry to measure the geometry of a distensible organ. The purpose of this study was to evaluate FLIP as a method to determine structural changes at the gastroesophageal junction (GEJ) following transoral incisionless fundoplication (TIF) and compare these findings with the accepted methods of esophageal testing. METHODS: Two different approaches (TIF1.0 and 2.0) using the EsophyX device were performed in six and five animals, respectively. Three dogs underwent a sham procedure. FLIP measurements were performed pre- and post-procedure and at 2-week follow-up. Upper endoscopy, manometry, and 48-h pH testing were also performed at each time point. FLIP was performed in ten patients before and 3 months after TIF. RESULTS: Following TIF procedures, there was a significant decrease in cross-sectional area (CSA) of GEJ compared to baseline; however, the CSA of both groups returned to baseline at 2-week follow-up. The FLIP results were supported with pH testing and correlated highly with both measures of GEJ structural integrity (LES and cardia circumference). Following TIF in humans, there was a decrease in GEJ distensibility compared to baseline that persisted to the 3-month evaluation. CONCLUSION: FLIP is able to measure and display changes in tissue distensibility at the GEJ, and results correlate with established methods of testing. FLIP may represent a single testing modality by which to diagnose GERD and evaluate the outcome after antireflux surgery

Sociologie du phénomène sportif

Réflexion sur la place du sport dans la société. Quand le sport, érigé en spectacle, tend à se fonder sur une logique économique au détriment de l'éthique sportive. Place de la médecine dans le débat autour de l'individu et de la pratique sportive

Video assisted esophagectomy for esophageal cancer

Video assisted surgery for esophageal cancer is an advanced surgical technique. It is being adopted with a concept of minimally invasive surgery. Since there are several options of the operative procedure for thoracic esophageal cancer, there are several laparoscopic approaches. The first VATS esophagectomy through a right thoracoscopic approach and the first transhiatal esophagectomy were reported in early 1990's. Mediastinoscope-assisted esophagectomy is also reported as a substitute of the blunt dissection of the esophagus. Moreover, video assisted Ivor-Lewis esophagectomy by right thoracotomy with intrathoracic anastomosis has also been tried. Furthermore, laparoscopic gastric mobilization and gastroplasty is also widely accepted as a substitution for open laparotomy. This article serves to review the literature on laparoscopic approaches for esophageal cancer