Short Myotomy for Megaesophagus
This study is evaluating whether a shorter myotomy is as effective as a standard length myotomy.
See full descriptionAbout the trial for Megaesophagus
Treatment Groups
This trial involves 2 different treatments. Short Myotomy is the primary treatment being studied. Participants will all receive the same treatment. Some patients will receive a placebo treatment. The treatments being tested are not being studied for commercial purposes.
Eligibility
This trial is for patients born any sex aged 18 and older. There are 2 eligibility criteria to participate in this trial as listed below.
Approximate Timelines
Measurement Requirements
This trial is evaluating whether Short Myotomy will improve 1 primary outcome and 3 secondary outcomes in patients with Megaesophagus. Measurement will happen over the course of 1 year.
Who is running the study
Principal InvestigatorPatient Q & A Section
Who should consider clinical trials for megaesophagus?
[Megaesophagus] was shown to be related to age, male sex, high BMI, dysphagia, and [other variables] (P<0.05). Clinical trials for the treatment of patients with megaesophagus may be necessary.
What causes megaesophagus?
Patients with megaesophagus are more likely to have a prior surgical or medical condition, such as malignancy or congenital deformity. The underlying cause of megacolon or malformation of the stomach cannot be determined, but it may be an isolated condition.
What are common treatments for megaesophagus?
There is no conclusive evidence on the efficacy of endoscopic therapy and other non-surgical treatments for megaesophagus. There is, however, some evidence for surgical therapy. In particular, endoscopic dilation and laser ablation have been used. Despite all of this, definitive surgical therapy of megaesophagus remains the treatment for choice by specialists.
Can megaesophagus be cured?
The majority of patients who have long-term symptoms have symptoms resolve with the use of proton pump inhibitors, but the risk of relapse is high. Recent findings support ongoing surveillance for symptom evolution and symptom alleviation.
What is megaesophagus?
Megaesophagus is an abnormally thickened muscular segment of the oesophageal wall in which a muscular gap can be seen on an upper GI endoscopy. Megaesophagus is not associated with pathological reflux.
What are the signs of megaesophagus?
The diagnosis of megaesophagus cannot be based on symptoms alone. A high degree of suspicion for megaesophagus is necessary for diagnosing the disorder early and preventing unnecessary investigations, unnecessary treatment and delays to surgery.
How many people get megaesophagus a year in the United States?
The incidence of megaesophagus is low, at around 1 per 100,000 per year. The incidence of megaesophagus remains fairly stable over time and over different age groups. It is most frequently diagnosed in older men with a history of peptic ulcer disease.
Does megaesophagus run in families?
No significant results (p < 0.05) were recorded in the frequency of megaesophagus among affected families and control families. This result may be due to the differences in occurrence in the families of some cases and also the small number of cases.
What are the latest developments in short myotomy for therapeutic use?
The short myotomy remains a commonly accepted treatment for achalasia, but recent technological advancements have created new treatment options for surgeons and endoscopists with the help of an advanced surgical endoscope.
Does short myotomy improve quality of life for those with megaesophagus?
MME for correction of oesophageal dysmotility does not improve the quality of life of patients at rest and during the day, and has a negative impact on the general health of patients.
Have there been any new discoveries for treating megaesophagus?
Because of the current availability of only one treatment method for megaesophagus, we believe that new treatment methods in this area are very necessary to develop the appropriate type of treatment and to select appropriate candidates for treatment.
Is short myotomy typically used in combination with any other treatments?
Patients treated with short myotomy with either endoscopic or open surgery typically respond well with improvement in cough, pain, and swallowing. The long-term results of these treatments are not clear because of the small sample size and our short follow-up at this time. Despite this study, surgeons and referral centers should continue their experience with short myotomy, because patients seem to have a higher success rate.