PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS
ABSTRACT BACKGROUND: Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2023-12-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202023000100341&tlng=en |
| _version_ | 1797394355646889984 |
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| author | Francisco Paulo Ponte PRADO JUNIOR Ivens Filizola Soares MACHADO Maria Paula Lopes Ponte PRADO Renato Bruno Cavalcante LEITE Samuel Magalhães GURGEL José Walter Feitosa GOMES José Huygens Parente GARCIA |
| author_facet | Francisco Paulo Ponte PRADO JUNIOR Ivens Filizola Soares MACHADO Maria Paula Lopes Ponte PRADO Renato Bruno Cavalcante LEITE Samuel Magalhães GURGEL José Walter Feitosa GOMES José Huygens Parente GARCIA |
| author_sort | Francisco Paulo Ponte PRADO JUNIOR |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the aim of improving patients’ symptoms. Peroral endoscopic myotomy (POEM) is an alternative endoscopic surgery to Heller cardiomyotomy, in which the procedure is performed orally, by endoscopy, offering efficacy comparable to surgical myotomy, with relative ease and minimal invasion, without external incisions. AIMS: To study the safety of POEM by analyzing its results, adverse events and perioperative complications and the main ways to overcome them, in addition to evaluating the effectiveness of the procedure and the short-term postoperative quality of life. METHODS: A qualitative and quantitative, observational and cross-sectional study that analyzed patients who underwent the POEM in a reference center, from December 2016 to December 2022, maintaining the technical standard of pre-, peri- and postoperative protocol. RESULTS: A total of 94 patients were included in the study, and only three had postoperative complications. The average early postoperative Eckardt score was 0.93 and the late 1.40, with a mean improvement of 7.1 in early results and 6.63 in late results (p<0.05). CONCLUSIONS: POEM can be reproduced with an excellent safety profile, significant relief of symptoms and improvement in esophageal emptying, and in quality of life. |
| first_indexed | 2024-03-09T00:17:27Z |
| format | Article |
| id | doaj.art-9b7650b4b85f4ce0b28ba4e2f1d52c9a |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-03-09T00:17:27Z |
| publishDate | 2023-12-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-9b7650b4b85f4ce0b28ba4e2f1d52c9a2023-12-12T07:46:02ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202023-12-013610.1590/0102-672020230066e1784PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTSFrancisco Paulo Ponte PRADO JUNIORhttps://orcid.org/0009-0009-2738-8512Ivens Filizola Soares MACHADOhttps://orcid.org/0000-0002-4798-214XMaria Paula Lopes Ponte PRADOhttps://orcid.org/0000-0001-8512-4915Renato Bruno Cavalcante LEITEhttps://orcid.org/0009-0003-5343-1170Samuel Magalhães GURGELhttps://orcid.org/0009-0000-1903-3484José Walter Feitosa GOMEShttps://orcid.org/0000-0002-7969-4927José Huygens Parente GARCIAhttps://orcid.org/0000-0003-4401-137XABSTRACT BACKGROUND: Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the aim of improving patients’ symptoms. Peroral endoscopic myotomy (POEM) is an alternative endoscopic surgery to Heller cardiomyotomy, in which the procedure is performed orally, by endoscopy, offering efficacy comparable to surgical myotomy, with relative ease and minimal invasion, without external incisions. AIMS: To study the safety of POEM by analyzing its results, adverse events and perioperative complications and the main ways to overcome them, in addition to evaluating the effectiveness of the procedure and the short-term postoperative quality of life. METHODS: A qualitative and quantitative, observational and cross-sectional study that analyzed patients who underwent the POEM in a reference center, from December 2016 to December 2022, maintaining the technical standard of pre-, peri- and postoperative protocol. RESULTS: A total of 94 patients were included in the study, and only three had postoperative complications. The average early postoperative Eckardt score was 0.93 and the late 1.40, with a mean improvement of 7.1 in early results and 6.63 in late results (p<0.05). CONCLUSIONS: POEM can be reproduced with an excellent safety profile, significant relief of symptoms and improvement in esophageal emptying, and in quality of life.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202023000100341&tlng=enDeglutition DisordersEndoscopyDigestive SystemEsophageal AchalasiaMyotomy |
| spellingShingle | Francisco Paulo Ponte PRADO JUNIOR Ivens Filizola Soares MACHADO Maria Paula Lopes Ponte PRADO Renato Bruno Cavalcante LEITE Samuel Magalhães GURGEL José Walter Feitosa GOMES José Huygens Parente GARCIA PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS ABCD: Arquivos Brasileiros de Cirurgia Digestiva Deglutition Disorders Endoscopy Digestive System Esophageal Achalasia Myotomy |
| title | PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS |
| title_full | PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS |
| title_fullStr | PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS |
| title_full_unstemmed | PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS |
| title_short | PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS |
| title_sort | peroral endoscopic myotomy for achalasia safety profile complications and results of 94 patients |
| topic | Deglutition Disorders Endoscopy Digestive System Esophageal Achalasia Myotomy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202023000100341&tlng=en |
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