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Per-oral endoscopic myotomy (POEM): mid-term efficacy and safety

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10375376" target="_blank" >RIV/00216208:11110/18:10375376 - isvavai.cz</a>

  • Alternative codes found

    RIV/61383082:_____/18:00000435 RIV/00216224:14110/18:00102802 RIV/00216208:11130/18:10375376 RIV/00669806:_____/18:10375376 and 3 more

  • Result on the web

    <a href="https://doi.org/10.1007/s00464-017-5807-3" target="_blank" >https://doi.org/10.1007/s00464-017-5807-3</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1007/s00464-017-5807-3" target="_blank" >10.1007/s00464-017-5807-3</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Per-oral endoscopic myotomy (POEM): mid-term efficacy and safety

  • Original language description

    Background and aims Per-oral endoscopic myotomy (POEM) is becoming a standard treatment for achalasia. Long-term efficacy and the rate of post-POEM reflux should be further investigated. The main aim of this study was to analyze safety and mid-term (12 and 24 months) clinical outcomes of POEM. Methods Data on single tertiary center procedures were collected prospectively. The primary outcome was treatment success defined as an Eckardt score &lt;3 at 12 and 24 months. A total of 155 consecutive patients with achalasia underwent POEM; 133 patients were included into the analysis (22 patients will be analyzed separately as part of a multicenter randomized clinical trial). Results POEM was successfully completed in 132 (99.2%) patients, and the mean length of the procedure was 69.8 min (range 31-136). One patient underwent a drainage for pleural effusion; no other serious adverse events occurred. Treatment success at 3, 12, and 24 months was observed in 95.5% (CI 89.6-98.1), 93.4% (86.5-96.8), and 84.0% (71.4-91.4) of patients, respectively. A total of 11 patients (8.3%) reported initial treatment failure (n = 5) or later recurrence (n = 6). The majority of relapses occurred in patients with achalasia type I (16.7 vs. 1.1% achalasia type II vs. 0% achalasia type III; p &lt; 0.05). At 12 months, post-POEM reflux symptoms were present in 29.7% of patients. At 3 months, mild reflux esophagitis was diagnosed in 37.6% of patients, and pathological gastroesophageal reflux was detected in 41.5% of patients. A total of 37.8% of patients had been treated with a proton pump inhibitor. Conclusion POEM resulted in greater than 90% treatment success at 12 months which tends to decrease to 84% after 2 years. More than one-third of the patients had mild reflux symptoms and/or mild esophagitis.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30212 - Surgery

Result continuities

  • Project

  • Continuities

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Others

  • Publication year

    2018

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Surgical Endoscopy

  • ISSN

    0930-2794

  • e-ISSN

  • Volume of the periodical

    32

  • Issue of the periodical within the volume

    3

  • Country of publishing house

    US - UNITED STATES

  • Number of pages

    10

  • Pages from-to

    1293-1302

  • UT code for WoS article

    000424654800027

  • EID of the result in the Scopus database

    2-s2.0-85027131312