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

Identifikátory výsledku

  • Kód výsledku v IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61988987%3A17110%2F18%3AA20020RI" target="_blank" >RIV/61988987:17110/18:A20020RI - isvavai.cz</a>

  • Nalezeny alternativní kódy

    RIV/61383082:_____/18:00000435 RIV/00216224:14110/18:00102802 RIV/00216208:11110/18:10375376 RIV/00216208:11130/18:10375376 a 3 dalších

  • Výsledek na webu

    <a href="https://link.springer.com/content/pdf/10.1007/s00464-017-5807-3.pdf" target="_blank" >https://link.springer.com/content/pdf/10.1007/s00464-017-5807-3.pdf</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>

Alternativní jazyky

  • Jazyk výsledku

    angličtina

  • Název v původním jazyce

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

  • Popis výsledku v původním jazyce

    Abstract 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.

  • Název v anglickém jazyce

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

  • Popis výsledku anglicky

    Abstract 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.

Klasifikace

  • Druh

    J<sub>imp</sub> - Článek v periodiku v databázi Web of Science

  • CEP obor

  • OECD FORD obor

    30219 - Gastroenterology and hepatology

Návaznosti výsledku

  • Projekt

  • Návaznosti

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Ostatní

  • Rok uplatnění

    2018

  • Kód důvěrnosti údajů

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

Údaje specifické pro druh výsledku

  • Název periodika

    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES

  • ISSN

    0930-2794

  • e-ISSN

    1432-2218

  • Svazek periodika

    32

  • Číslo periodika v rámci svazku

    3

  • Stát vydavatele periodika

    US - Spojené státy americké

  • Počet stran výsledku

    9

  • Strana od-do

    1293-1302

  • Kód UT WoS článku

    000424654800027

  • EID výsledku v databázi Scopus