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Prospective evaluation of the efficacy of peroral endoscopic myotomy in patients with achalasia

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Abstract
Peroral endoscopic myotomy (POEM) is an endoscopic alternative to surgical myotomy in patients with achalasia. This study aimed to evaluate the efficacy and clinical outcomes of POEM. A total of 20 patients with achalasia who underwent POEM between October 2016 and November 2017 were prospectively recruited. The intraoperative esophagogastric junction distensibility index (mm(2)/mm Hg) was measured pre- and post-myotomy using an endoluminal functional lumen imaging probe. Clinical response was defined as Eckardt score <= 3. Health-related quality of life was measured by the 36-item short-form health survey score. POEM was successfully completed in all cases. The median procedure time was 68.5 minutes (range 50.0-120.0), and the median myotomy length was 13 cm (range 11-18). Major adverse events were encountered in 2 cases. Overall, clinical responses were observed in all patients during a median follow-up of 11.9 months (range 1.2-26.2). Postoperative esophagogastric junction distensibility index was significantly higher than baseline (from 1.3 [range 0.8-6.9] to 6.3 [range 25-19.2], P < .001). The median Eckardt scores were decreased after POEM (5 [range 2-11] to 1 [range 0-3], P < .001), and the 36-item short-form health survey score was also improved significantly after POEM (67.5 [range 34.5-93.9] to 85.7 [range 53.4-93.3], P = .004). POEM is an effective treatment for achalasia, based on the improvement of both symptoms and objective measures. Clinicaltrial.gov NCT 02989883
Author(s)
공은정나희경안지용정기욱김도훈최기돈송호준정훈용
Issued Date
2021
Type
Article
Keyword
4500Abridged Index MedicusachalasiamyotomyObservational Studysymptom assessment
DOI
10.1097/MD.0000000000026248
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7057
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8202605&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Prospective%20evaluation%20of%20the%20efficacy%20of%20peroral%20endoscopic%20myotomy%20in%20patients%20with%20achalasia&amp;offset=0&amp;pcAvailability=true
Publisher
MEDICINE
Language
한국어
ISSN
0025-7974
Citation Volume
100
Citation Number
23
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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