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...
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Georg Thieme Verlag KG
2021
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oai:doaj.org-article:781ec349b98d4b299f0cd58a687684052021-11-13T00:00:31ZDurability of per-oral endoscopic myotomy beyond 6 years2364-37222196-973610.1055/a-1553-9846https://doaj.org/article/781ec349b98d4b299f0cd58a687684052021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/a-1553-9846https://doaj.org/toc/2364-3722https://doaj.org/toc/2196-9736Background 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.Jad P. AbiMansourYervant IchkhanianHitomi MinamiPietro FamiliariRosario LandiGuido CostamagnaStefan SeewaldZachary M. CallahanMichael B. UjikiMathieu PiocheThierry PonchonSabine RomanJoo Young ChoIn Kyung YooMegan SippeyJeffrey M. MarksNikolas EleftheriadisVivek KhumbariOlaya I. Brewer GutierrezMouen A. KhashabGeorg Thieme Verlag KGarticleDiseases of the digestive system. GastroenterologyRC799-869ENEndoscopy International Open, Vol 09, Iss 11, Pp E1595-E1601 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Diseases of the digestive system. Gastroenterology RC799-869 |
| spellingShingle |
Diseases of the digestive system. Gastroenterology RC799-869 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 |
| 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. |
| format |
article |
| 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 |
| title |
Durability of per-oral endoscopic myotomy beyond 6 years |
| title_short |
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_sort |
durability of per-oral endoscopic myotomy beyond 6 years |
| publisher |
Georg Thieme Verlag KG |
| publishDate |
2021 |
| url |
https://doaj.org/article/781ec349b98d4b299f0cd58a68768405 |
| work_keys_str_mv |
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