Durability of per-oral endoscopic myotomy beyond 6 years
Background and study aims The aim of this study was to assess long-term clinical outcomes beyond 6 years in patients who underwent per-oral endoscopic myotomy (POEM) for the treatment of achalasia. Patients and methods Patients with achalasia who underwent POEM between 2010 and 2012 and h...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2021-11-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1553-9846 |
| _version_ | 1818398400548175872 |
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| author | Jad P. AbiMansour Yervant Ichkhanian Hitomi Minami Pietro Familiari Rosario Landi Guido Costamagna Stefan Seewald Zachary M. Callahan Michael B. Ujiki Mathieu Pioche Thierry Ponchon Sabine Roman Joo Young Cho In Kyung Yoo Megan Sippey Jeffrey M. Marks Nikolas Eleftheriadis Vivek Khumbari Olaya I. Brewer Gutierrez Mouen A. Khashab |
| author_facet | Jad P. AbiMansour Yervant Ichkhanian Hitomi Minami Pietro Familiari Rosario Landi Guido Costamagna Stefan Seewald Zachary M. Callahan Michael B. Ujiki Mathieu Pioche Thierry Ponchon Sabine Roman Joo Young Cho In Kyung Yoo Megan Sippey Jeffrey M. Marks Nikolas Eleftheriadis Vivek Khumbari Olaya I. Brewer Gutierrez Mouen A. Khashab |
| author_sort | Jad P. AbiMansour |
| collection | DOAJ |
| description | Background and study aims The aim of this study was to assess long-term clinical outcomes beyond 6 years in patients who underwent per-oral endoscopic myotomy (POEM) for the treatment of achalasia.
Patients and methods Patients with achalasia who underwent POEM between 2010 and 2012 and had follow-up of at least 6 years were retrospectively identified at eight tertiary care centers. The primary outcome evaluated was clinical success defined by an Eckardt symptom score (ESS) ≤ 3 for the duration of the follow-up period. The clinical success cohort was compared to failure (ESS > 3 at any time during follow-up) in order to identify characteristics associated with symptom relapse. The incidence of patient-reported gastroesophageal reflux (GER) was also evaluated.
Results Seventy-three patients with 6-year follow-up data were identified. Sustained clinical remission was noted in 89 % (65/73) at 6-years. Mean ESS decreased from 7.1 ± 2.3 pre-procedure to 1.1 ± 1.1 at 6 years (P < 0.001). Symptomatic reflux was reported by 27 of 72 patients (37.5 %). Type I achalasia (OR 10.8, P = 0.04) was found to be associated with clinical failure on logistic regression analysis.
Conclusions In patients with achalasia, POEM provides high initial clinical success with excellent long-term outcomes. There are high rates of patient-reported gastroesophageal reflux post-procedure which persist at long-term follow-up. |
| first_indexed | 2024-12-14T07:04:11Z |
| format | Article |
| id | doaj.art-781ec349b98d4b299f0cd58a68768405 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-14T07:04:11Z |
| publishDate | 2021-11-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-781ec349b98d4b299f0cd58a687684052022-12-21T23:12:18ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362021-11-010911E1595E160110.1055/a-1553-9846Durability of per-oral endoscopic myotomy beyond 6 yearsJad P. AbiMansour0Yervant Ichkhanian1Hitomi Minami2Pietro Familiari3Rosario Landi4Guido Costamagna5Stefan Seewald6Zachary M. Callahan7Michael B. Ujiki8Mathieu Pioche9Thierry Ponchon10Sabine Roman11Joo Young Cho12In Kyung Yoo13Megan Sippey14Jeffrey M. Marks15Nikolas Eleftheriadis16Vivek Khumbari17Olaya I. Brewer Gutierrez18Mouen A. Khashab19Division of Gastroenterology and Hepatology Johns Hopkins Hospital, Baltimore, USADivision of Gastroenterology and Hepatology Johns Hopkins Hospital, Baltimore, USADepartment of Gastroenterology and Hepatology Nagasaki University Hospital Nagasaki, JapanDigestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, ItalyDigestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, ItalyDigestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, ItalyCenter of Gastroenterology Hirslanden Private Clinic Group Zürich, SwitzerlandDepartment of Surgery NorthShore University HealthSystem Evanston, USADepartment of Surgery NorthShore University HealthSystem Evanston, USAGastroenterology Unit/Unit of Functional Disease and Digestive Physiology Edouard Herriot Hospital Lyon, FranceGastroenterology Unit/Unit of Functional Disease and Digestive Physiology Edouard Herriot Hospital Lyon, FranceGastroenterology Unit/Unit of Functional Disease and Digestive Physiology Edouard Herriot Hospital Lyon, FranceDepartment of Gastroenterology, Cha Bundang Medical Center, Cha University College of Medicine, Seongnam-si, KoreaDepartment of Gastroenterology, Cha Bundang Medical Center, Cha University College of Medicine, Seongnam-si, KoreaCase Western/University Hospitals Cleveland Medical Center, Cleveland, USACase Western/University Hospitals Cleveland Medical Center, Cleveland, USAMetropolitan Hospital, Athens, GreeceDivision of Gastroenterology and Hepatology Johns Hopkins Hospital, Baltimore, USADivision of Gastroenterology and Hepatology Johns Hopkins Hospital, Baltimore, USADivision of Gastroenterology and Hepatology Johns Hopkins Hospital, Baltimore, USABackground and study aims The aim of this study was to assess long-term clinical outcomes beyond 6 years in patients who underwent per-oral endoscopic myotomy (POEM) for the treatment of achalasia. Patients and methods Patients with achalasia who underwent POEM between 2010 and 2012 and had follow-up of at least 6 years were retrospectively identified at eight tertiary care centers. The primary outcome evaluated was clinical success defined by an Eckardt symptom score (ESS) ≤ 3 for the duration of the follow-up period. The clinical success cohort was compared to failure (ESS > 3 at any time during follow-up) in order to identify characteristics associated with symptom relapse. The incidence of patient-reported gastroesophageal reflux (GER) was also evaluated. Results Seventy-three patients with 6-year follow-up data were identified. Sustained clinical remission was noted in 89 % (65/73) at 6-years. Mean ESS decreased from 7.1 ± 2.3 pre-procedure to 1.1 ± 1.1 at 6 years (P < 0.001). Symptomatic reflux was reported by 27 of 72 patients (37.5 %). Type I achalasia (OR 10.8, P = 0.04) was found to be associated with clinical failure on logistic regression analysis. Conclusions In patients with achalasia, POEM provides high initial clinical success with excellent long-term outcomes. There are high rates of patient-reported gastroesophageal reflux post-procedure which persist at long-term follow-up.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1553-9846 |
| spellingShingle | Jad P. AbiMansour Yervant Ichkhanian Hitomi Minami Pietro Familiari Rosario Landi Guido Costamagna Stefan Seewald Zachary M. Callahan Michael B. Ujiki Mathieu Pioche Thierry Ponchon Sabine Roman Joo Young Cho In Kyung Yoo Megan Sippey Jeffrey M. Marks Nikolas Eleftheriadis Vivek Khumbari Olaya I. Brewer Gutierrez Mouen A. Khashab Durability of per-oral endoscopic myotomy beyond 6 years Endoscopy International Open |
| title | Durability of per-oral endoscopic myotomy beyond 6 years |
| title_full | Durability of per-oral endoscopic myotomy beyond 6 years |
| title_fullStr | Durability of per-oral endoscopic myotomy beyond 6 years |
| title_full_unstemmed | Durability of per-oral endoscopic myotomy beyond 6 years |
| title_short | Durability of per-oral endoscopic myotomy beyond 6 years |
| title_sort | durability of per oral endoscopic myotomy beyond 6 years |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1553-9846 |
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