THANK YOU TO EVERYONE WHO MADE THE 2017 COURSE A SUCCESS! 

Course Overview

This is the 32nd year of the annual course “Medical and Surgical Aspects of Esophageal and Foregut Disorders: Pathophysiology and Treatment”.  We are pleased to once again bring thought leaders in the field of esophageal disease as our special guests to join the outstanding faculty for a unique week of in-depth learning, lively discussion, and social interaction.  As always, the mix of specialties enhances the educational format and promotes thoughtful discussion as controversial topics and concepts are explored.  Joining us from the surgical side this year will be Dr. Lars Lundell and from the medical side Dr. Hashem El-Serag.

Dr. Lars Lundell is Professor of Surgery at the famed Karolinska University Hospital in Stockholm, Sweden. He has over 250 peer-reviewed publications and is internationally known for his leadership in randomized control trials comparing antireflux surgery and PPI therapy for gastroesophageal reflux disease.

Dr. Hashem El-Serag is the Dan L. Duncan Endowed Professor of Medicine, Baylor College of Medicine and the Director of the Texas Digestive Disease Center, Baylor College of Medicine. He is Editor-in-Chief of Clinical Gastroenterology and Hepatology and Associate Editor of Gastroenterology. He has over 370 peer-reviewed publications and is a recognized authority on the epidemiology of GERD, Barrett’s esophagus and esophageal adenocarcinoma.

We are also pleased to have an outstanding faculty this year including Lee Swanstrom, Kevin Reavis, Dan Oh, Stu Spechler, David Katzka, and Para Chandrasoma along with prior directors Don Castell and Tom DeMeester, current co-directors Philip Katz and Steve DeMeester and Associate Director Jeff Peters.

The aim of this course is to discuss in detail the pathophysiology, diagnosis and therapy of diseases of the esophagus and foregut.  The course is specifically designed to be a classroom environment for a small group of interested physicians and allied health personnel. The course is particularly appreciated by gastroenterologists and gastrointestinal surgeons with interest in esophageal disorders and for those who have set up a swallowing center and function as a team to collaboratively approach esophageal problems.  The lectures are designed to encourage discussion on a broad variety of esophageal topics including both benign and malignant disorders.  For those of you that have been before you know that the lively discussion often produces the most interesting concepts and wipes away ingrained biases with the penetrating light of scientific data!

Highlights of this year’s course will be an interactive session on upper endoscopic findings using an audience response system and prizes for the winners, a not to be missed session on the development of antireflux medications, and presentations on novel endoscopic therapies for sphincter and motility abnormalities in the esophagus and stomach.  Also featured will be discussions about novel GERD therapies, the science behind PPI induced vascular disease and the legitimacy of concerns with these medications, management of the bariatric patient with GERD, a debate on which patients with paraesophageal hernias should undergo repair, the role of mesh at the hiatus, the epidemiology of GERD, Barrett’s and esophageal cancer, and new insights into the outcome with endoscopic and surgical management of early stage esophageal adenocarcinoma.  Participants will be introduced to the latest technologies for esophageal diagnostics and intervention and have the opportunity to learn the application and use of these devices during the Saturday “hands-on” break-out sessions.  We do everything possible to ensure that the course will be an interesting, informative and enjoyable educational experience. 


ACCREDITATION

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Surgeons and Foundation for Research and Education in Esophageal and Foregut Disease. The American College of Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

AMA PRA Category 1 Credits™: The American College of Surgeons designates this live activity for a maximum of 26.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABS MOC Program: This activity will also provide self-assessment credits towards Part 2 of the ABS MOC Program. In order to claim self-assessment credits toward Part 2 of the American Board of Surgery (ABS) Maintenance of Certification (MOC) Program, eligible learners must complete and pass (75% passing rate) a graded quiz. Please note that only ABS qualified surgeons are eligible for MOC credit.

Of the AMA PRA Category 1 Credits™ listed above, a maximum of 24.25 credits meet the requirements for Self-Assessment.

Learning Objectives

This activity is designed for physicians and allied health personnel with an interest in esophageal and foregut disorders and is particularly appreciated by gastroenterologists and gastrointestinal surgeons who focus on the diagnosis and treatment of patients with esophageal disorders. Upon completion of this course, participants will be able to:

  1. Describe the normal function and pathophysiology of the esophageal sphincters and esophageal body

  2.  Interpret the results of esophageal physiologic diagnostic testing including high-resolution manometry, pH testing and novel technologies including optical coherence tomography and endomicroscopy.

  3.  Describe the traditional and novel therapies available for the endoscopic and surgical management of benign esophageal disease 

  4.  Recognize the indications for upper endoscopy and apply the guidelines for surveillance and endoscopic treatment of esophageal premalignant conditions.

  5.  Explain the staging for esophageal cancer and analyze the options for chemotherapy, radiotherapy and esophageal resection.


Agenda

CME Credits
Thursday, February 2
6:30 A.M.Continental Breakfast/Indroductions and WelcomeDr. S DeMeester
Dr. Katz
Session 1: Anatomy, Physiology and Evaluation of the Esophagus
7:00 A.M.Evolution of Esophageal Functional Testing0.75Dr. Castell
7:45 A.M.Discussion0.25 
8:00 A.M.The Role of the LES in the Inception and Progression of GERD0.75Dr T DeMeester
8:45 A.M.Discussion0.25 
9:00 A.M.HRM and the Updated Chicago Classification System0.75Dr. Katz
9:45 A.M.Discussion0.25 
10:00 A.M.Coffee Break and Case Discussions 
10:30 A.M.Options for Diagnostic Testing in Esophageal Disease0.75Dr. S DeMeester
11:15 A.M.Discussion0.25 
11:30 A.M.Endoscopy: Optimal Use in Esophageal Disease and the Super Bowl of Upper Endoscopy (Audience Response)1.25Dr. Katzka
12:45 P.M.Adjourn 
6:30 P.M.WELCOME RECEPTION 
Friday, February 3
Session 2: Paraesophageal Hernia
6:10 A.M.Early Risers Video Session: Case-PEH repair 
6:30 A.M.Continental Breakfast/Case Presentation: PEH0.75Portland
7:00 A.M.Is There a Role for Mesh at the Hiatus?0.50Dr. Reavis
7:30 A.M.Discussion0.25 
7:45 A.M.Recurrence after PEH Repair: Is “Pretty Good” Good Enough?0.50Dr. S DeMeester
8:15 A.M.Discussion0.25 
8:30 A.M.Debate: Paraesophageal Hernias: Is it Time to Fix Them All (Again)?0.75PRO: Dr. Oh
CON: Dr. Spechler
9:15 A.M.Discussion0.25 
9:30 A.M.Coffee Break and Case Presentations 
Session 3: GERD and Proton Pump Inhibitor Therapy
10:15 A.M.The Development of PPI’s and Beyond0.75Dr. Lundell
11:00 A.M.Discussion0.25 
11:15 A.M.Scientific Basis for PPI Induced Vascular Disease0.50Dr. Spechler
11:45 A.M.Discussion0.25 
12:00 P.M.Should New Evidence Change How We Use PPI’s?0.50Dr. Katz
12:30 P.M.Discussion0.25 
12:45 P.M.Adjourn 
Saturday, February 4
Session 4: Gastroesophageal Reflux Disease: Innovations in Diagnosis and Treatment
6:10 A.M.Early Risers Video Session: Case- EndoStim for GERD0.25 
6:30 A.M.What is Required for a New GERD Technology to be Adopted Into the Mainstream?0.50Dr. Peters
7:10 A.M.Discussion0.25 
7:15 A.M.Hands-On Breakout Sessions: Sessions 1-5 (Sessions will be @ 30 mins each) 
 Five Simultaneous Sessions Will Be Presented At 7:30am, 8:00am, 8:30am, 9:00am, and 9:30am . Simultaneous Sessions Include: 
 1. Esophageal Function Testing Via MII and Impedance Reflux TestingDr. Castell
Dr. Katz
 2. Advanced Imaging for the EsophagusDr. Oh
 3. Enhanced Esophageal Biopsy and Tissue AnalysisDr. S DeMeester
 4. Assessing Dysphagia with EndoFlIP During EndoscopyDr. Reavis
Dr. Katzka
 5. Comprehensive Esophageal Assessment of GERD Patients With CellvizioDr. Swanstrom
Dr. Spechler
9:45 A.M.Coffee Break and Case Discussions 
10:00 A.M.Pathology and Pathophysiology of GERD0.75Dr. Chandrasoma
10:45 A.M.Discussion0.25 
11:00 A.M.Epidemiology of GERD and the Role of Lifestyle Interventions0.75Dr. El-Serag
11:45 A.M.Discussion0.25 
12:00 P.M.TIF, MUSE, and EndoStim for GERD0.50Dr. Reavis
12:30 P.M.Discussion0.25 
12:45 P.M.Adjourn 
Sunday, February 5 – FREE DAY: Super Bowl Sunday!
Monday, February 6
Session 5: Gastroesophageal Reflux Disease: Surgical Management
6:10 A.M.Early Risers Video Session: Case- LINX with Hiatal Hernia 
6:30 A.M.Continental Breakfast/Case Presentation: GERD0.75Einstein
7:00 A.M.PPI vs Fundoplication in RCT’s0.75Dr. Lundell
7:45 A.M.Discussion0.25 
8:00 A.M.Surgical Options for GERD Management: LINX and Fundoplication0.75Dr. Swanstrom
8:45 A.M.Discussion0.25 
9:00 A.M.Interface of Bariatric Surgery and GERD0.50Dr. Reavis
9:30 A.M.Discussion0.25 
9:45 A.M.Coffee Break and Case Discussions 
Session 6: Achalasia and Motility Disorders
10:00 A.M.Achalasia: Demographics, Etiology, Subtypes and Medical Management0.50Dr. Katz
10:30 A.M.Discussion0.25 
10:45 A.M.Candidates, Outcomes, and Insight into Endoscopic Management Of Sphincter and Motility Disorders0.75Dr. Swanstrom
11:30 A.M.Discussion0.25 
11:45 A.M.Evaluation and Management of Dysphagia After Prior Achalasia Therapy0.50Dr. Katzka
12:15 P.M.Discussion0.25 
12:30 P.M.Adjourn 
4:30 P.M.COURSE DINNER 
Tuesday, February 7
Session 7: Barrett's Esophagus
6:10 A.M.Early Risers Video Session: Case- ESD for the Esophagus 
6:30 A.M.Continental Breakfast/Case Presentation: Barrett's0.75Mayo
7:00 A.M.Epidemiology of Barrett's and Esophageal Adenocarcinoma and the Role of Screening and Surveillance0.75Dr. El-Serag
7:45 A.M.Discussion0.25 
8:00 A.M.If Progression of BE is so Rare, Why is Esophageal Adenocarcinoma Still Increasing?0.75Dr. Spechler
8:45 A.M.Discussion0.25 
9:00 A.M.Antireflux Surgery, Barrett's Progression and the Swedish Data0.75Dr. Lundell
9:45 A.M.Discussion0.25 
10:00 A.M.Coffee Break and Case Discussions 
Session 8: Endoscopic and Surgical Management of Dysplasia and Adenocarcinoma
10:30 A.M.Barrett's Ablation: Who, How, and Then What?0.75Dr. Katzka
11:15 A.M.Discussion0.25 
11:30 A.M.Patient, Procedure Selection and Long-Term Outcomes With Endotherapy for Early Esophageal Cancer0.50Dr. Oh
12:00 P.M.Management of the Patient with T1b Adenocarcinoma0.50Dr. S DeMeester
12:30 P.M.Discussion0.25 
12:45 P.M.Adjourn