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Neurogastroenterology and Motility Jan 2021Chicago Classification v4.0 (CCv4.0) is the updated classification scheme for esophageal motility disorders using metrics from high-resolution manometry (HRM). Fifty-two... (Review)
Review
Chicago Classification v4.0 (CCv4.0) is the updated classification scheme for esophageal motility disorders using metrics from high-resolution manometry (HRM). Fifty-two diverse international experts separated into seven working subgroups utilized formal validated methodologies over two-years to develop CCv4.0. Key updates in CCv.4.0 consist of a more rigorous and expansive HRM protocol that incorporates supine and upright test positions as well as provocative testing, a refined definition of esophagogastric junction (EGJ) outflow obstruction (EGJOO), more stringent diagnostic criteria for ineffective esophageal motility and description of baseline EGJ metrics. Further, the CCv4.0 sought to define motility disorder diagnoses as conclusive and inconclusive based on associated symptoms, and findings on provocative testing as well as supportive testing with barium esophagram with tablet and/or functional lumen imaging probe. These changes attempt to minimize ambiguity in prior iterations of Chicago Classification and provide more standardized and rigorous criteria for patterns of disorders of peristalsis and obstruction at the EGJ.
Topics: Esophageal Achalasia; Esophageal Motility Disorders; Esophageal Spasm, Diffuse; Esophagogastric Junction; Humans; Manometry
PubMed: 33373111
DOI: 10.1111/nmo.14058 -
World Journal of Emergency Surgery :... 2019The esophagus traverses three body compartments (neck, thorax, and abdomen) and is surrounded at each level by vital organs. Injuries to the esophagus may be classified... (Review)
Review
The esophagus traverses three body compartments (neck, thorax, and abdomen) and is surrounded at each level by vital organs. Injuries to the esophagus may be classified as foreign body ingestion, caustic ingestion, esophageal perforation, and esophageal trauma. These lesions can be life-threatening either by digestive contamination of surrounding structures in case of esophageal wall breach or concomitant damage of surrounding organs. Early diagnosis and timely therapeutic intervention are the keys of successful management.
Topics: Caustics; Esophageal Perforation; Esophagoscopy; Esophagus; Foreign Bodies; Humans; Tomography, X-Ray Computed
PubMed: 31164915
DOI: 10.1186/s13017-019-0245-2 -
Journal of Thoracic Disease Jun 2022Slovenia is a small country in the Southeastern part of Europe with a Gross Domestic Product slightly below the European average. There are eleven board-certified... (Review)
Review
Slovenia is a small country in the Southeastern part of Europe with a Gross Domestic Product slightly below the European average. There are eleven board-certified thoracic surgeons and four residents, dealing with roughly 2,500 thoracic cases per year. Thoracic Surgery in Slovenia is a challenging surgical specialty covering a wide range of problems such as lung cancer and other thoracic cancers, diseases of the esophagus, airway surgery, interventional endoscopy, pediatric thoracic surgery, lung transplantation, and even some nonthoracic problems such as surgery of the thyroid and parathyroid. Slovenian patients certainly enjoy the privilege of having free access to almost everything contemporary thoracic surgery can offer, including the most complex and least invasive procedures. In 2008 Slovenia was the first country in South-eastern Europe to adopt video-assisted thoracoscopic surgery (VATS) to treat lung cancer and other malignant diseases. It has also played an essential role in spreading the technique to neighboring countries. Slovenia also has a very successful lung transplantation program. On the other hand, most of the infrastructure is outdated, with both university hospitals built in the 1970s unable to provide a very comfortable hospital stay or increase their operating room capacities to meet the increased demand, thus waiting times for procedures of lesser priority, such as laparoscopic fundoplication and thyroidectomy became unacceptably long.
PubMed: 35813744
DOI: 10.21037/jtd-21-1172