Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter study
| Autor: | Mouen A. Khashab, Michael B. Ujiki, Amol Bapaye, Rosario Landi, Robert A. Moran, Stefan Seewald, Pietro Familiari, Anant Agarwalla, Sabine Roman, Nikolas Eleftheriadis, Martina Invernizzi, H. Mason Hedberg, Amyn Haji, Vivek Kumbhari, Bu Hayee, Saowanee Ngamruengphong, Thierry Ponchon, Lea Fayad, Yervant Ichkhanian, Mathieu Pioche, In Kyung Yoo, Mohamad Dbouk, François Mion, Joo Young Cho, Marcel Tantau, Nasim Parsa, Olaya I. Brewer Gutierrez, Omid Sanaei, Maximilien Barret, Guido Costamagna |
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| Rok vydání: | 2019 |
| Předmět: |
Myotomy
Heller myotomy medicine.medical_specialty Original article medicine.diagnostic_test business.industry medicine.medical_treatment Reflux Achalasia medicine.disease Endoscopy Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine 030211 gastroenterology & hepatology Pharmacology (medical) lcsh:Diseases of the digestive system. Gastroenterology Reflux esophagitis lcsh:RC799-869 Adverse effect business Cohort study |
| Zdroj: | Endoscopy International Open Endoscopy International Open, Vol 08, Iss 05, Pp E650-E655 (2020) |
| ISSN: | 2364-3722 |
| Popis: | Background and study aims Per-oral endoscopic myotomy (POEM) is associated with a short-term clinical response of 82 % to 100 % in treatment of patients with achalasia. Data are limited on the long-term durability of the clinical response in these patients. The aim of this study was to determine the long-term outcomes of patients undergoing POEM for management of achalasia. Methods This was a retrospective multicenter cohort study of consecutive patients who underwent POEM for management of achalasia. Patients had a minimum of 4 years follow-up. Clinical response was defined by an Eckardt score ≤ 3. Results A total of 146 patients were included from 11 academic medical centers. Mean (± SD) age was 49.8 (± 16) years and 79 (54 %) were female. The most common type of achalasia was type II, seen in 70 (47.9 %) patients, followed by type I seen in 41 (28.1 %) patients. Prior treatments included: pneumatic dilation in 29 (19.9 %), botulinum toxin injection in 13 (8.9 %) and Heller myotomy in seven patients (4.8 %). Eight adverse events occurred (6 mucosotomies, 2 pneumothorax) in eight patients (5.5 %). Median follow-up duration was 55 months (IQR 49.9–60.6). Clinical response was observed in 139 (95.2 %) patients at follow-up of ≥ 48 months. Symptomatic reflux after POEM was seen in 45 (32.1 %) patients, while 35.3 % of patients were using daily PPI at 48 months post POEM. Reflux esophagitis was noted in 16.8 % of patients who underwent endoscopy. Conclusion POEM is a durable and safe procedure with an acceptably low adverse event rate and an excellent long-term clinical response. |
| Databáze: | OpenAIRE |
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