Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter study
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...
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2020-04-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1120-8125 |
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| author | Olaya I. Brewer Gutierrez Robert A. Moran Pietro Familiari Mohamad H. Dbouk Guido Costamagna Yervant Ichkhanian Stefan Seewald Amol Bapaye Joo Young Cho Maximilien Barret Nikolas Eleftheriadis Mathieu Pioche Bu' Hussain Hayee Marcel Tantau Michael Ujiki Rosario Landi Martina Invernizzi In Kyung Yoo Sabine Roman Amyn Haji H. Mason Hedberg Nasim Parsa Francois Mion Lea Fayad Vivek Kumbhari Anant Agarwalla Saowanee Ngamruengphong Omid Sanaei Thierry Ponchon Mouen A. Khashab |
| author_facet | Olaya I. Brewer Gutierrez Robert A. Moran Pietro Familiari Mohamad H. Dbouk Guido Costamagna Yervant Ichkhanian Stefan Seewald Amol Bapaye Joo Young Cho Maximilien Barret Nikolas Eleftheriadis Mathieu Pioche Bu' Hussain Hayee Marcel Tantau Michael Ujiki Rosario Landi Martina Invernizzi In Kyung Yoo Sabine Roman Amyn Haji H. Mason Hedberg Nasim Parsa Francois Mion Lea Fayad Vivek Kumbhari Anant Agarwalla Saowanee Ngamruengphong Omid Sanaei Thierry Ponchon Mouen A. Khashab |
| author_sort | Olaya I. Brewer Gutierrez |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T04:00:53Z |
| format | Article |
| id | doaj.art-4d2ada8bd611449eab978854305907ee |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-13T04:00:53Z |
| publishDate | 2020-04-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-4d2ada8bd611449eab978854305907ee2022-12-22T03:03:29ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362020-04-010805E650E65510.1055/a-1120-8125Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter studyOlaya I. Brewer Gutierrez0Robert A. Moran1Pietro Familiari2Mohamad H. Dbouk3Guido Costamagna4Yervant Ichkhanian5Stefan Seewald6Amol Bapaye7Joo Young Cho8Maximilien Barret9Nikolas Eleftheriadis10Mathieu Pioche11Bu' Hussain Hayee12Marcel Tantau13Michael Ujiki14Rosario Landi15Martina Invernizzi16In Kyung Yoo17Sabine Roman18Amyn Haji19H. Mason Hedberg20Nasim Parsa21Francois Mion22Lea Fayad23Vivek Kumbhari24Anant Agarwalla25Saowanee Ngamruengphong26Omid Sanaei27Thierry Ponchon28Mouen A. Khashab29Division of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesDepartment of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina, United StatesDigestive Endoscopy Unit – Gemelli University Hospital,Rome, ItalyDivision of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesDigestive Endoscopy Unit – Gemelli University Hospital,Rome, ItalyDivision of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesCenter of Gastroenterolgy Hirslanden Private Clinic Group Witellikerstrasse 40, 8032 ZürichShivanand Desai Centre for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Centre, Pune, IndiaDigestive Endoscopy Center, CHA Bundang Hospital, South KoreaDepartment of gastroenterology, Cochin Hospital Paris, FranceMetropolitan Hospital, Athens, GreeceGastroenterology unit/unit of functional disease and digestive physiology, Edouard Herriot hospital, Lion, FranceInstitute of Therapeutic Endoscopy, Kingʼs College Hospital NHS Foundation Trust, London, UKIuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaNorthShore University HealthSystem/University of Chicago Medical Center, Chicago, United StatesDigestive Endoscopy Unit – Gemelli University Hospital,Rome, ItalyCenter of Gastroenterolgy Hirslanden Private Clinic Group Witellikerstrasse 40, 8032 ZürichDigestive Endoscopy Center, CHA Bundang Hospital, South KoreaGastroenterology unit/unit of functional disease and digestive physiology, Edouard Herriot hospital, Lion, FranceInstitute of Therapeutic Endoscopy, Kingʼs College Hospital NHS Foundation Trust, London, UKNorthShore University HealthSystem/University of Chicago Medical Center, Chicago, United StatesDivision of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesGastroenterology unit/unit of functional disease and digestive physiology, Edouard Herriot hospital, Lion, FranceDivision of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesDivision of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesDivision of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesDivision of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesDivision of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesGastroenterology unit/unit of functional disease and digestive physiology, Edouard Herriot hospital, Lion, FranceDivision of gastroenterology and hepatology Johns Hopkins Hospital, Baltimore, United StatesBackground 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.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1120-8125 |
| spellingShingle | Olaya I. Brewer Gutierrez Robert A. Moran Pietro Familiari Mohamad H. Dbouk Guido Costamagna Yervant Ichkhanian Stefan Seewald Amol Bapaye Joo Young Cho Maximilien Barret Nikolas Eleftheriadis Mathieu Pioche Bu' Hussain Hayee Marcel Tantau Michael Ujiki Rosario Landi Martina Invernizzi In Kyung Yoo Sabine Roman Amyn Haji H. Mason Hedberg Nasim Parsa Francois Mion Lea Fayad Vivek Kumbhari Anant Agarwalla Saowanee Ngamruengphong Omid Sanaei Thierry Ponchon Mouen A. Khashab Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter study Endoscopy International Open |
| title | Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter study |
| title_full | Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter study |
| title_fullStr | Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter study |
| title_full_unstemmed | Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter study |
| title_short | Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter study |
| title_sort | long term outcomes of per oral endoscopic myotomy in achalasia patients with a minimum follow up of 4 years a multicenter study |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1120-8125 |
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