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 gastro-esophageal reflux post-procedure which persist at long-term follow-up.

Abimansour, J. P., Ichkhanian, Y., Minami, H., Familiari, P., Landi, R., Costamagna, G., Seewald, S., Callahan, Z. M., Ujiki, M. B., Pioche, M., Ponchon, T., Roman, S., Cho, J. Y., Yoo, I. K., Sippey, M., Marks, J. M., Eleftheriadis, N., Khumbari, V., Gutierrez, O. I. B., Khashab, M. A., Durability of per-oral endoscopic myotomy beyond 6 years, <<ENDOSCOPY INTERNATIONAL OPEN>>, 2021; 9 (11): E1595-E1601. [doi:10.1055/a-1553-9846] [https://hdl.handle.net/10807/229454]

Durability of per-oral endoscopic myotomy beyond 6 years

Familiari, Pietro;Landi, Rosario;Costamagna, Guido;
2021

Abstract

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 gastro-esophageal reflux post-procedure which persist at long-term follow-up.
2021
Inglese
Abimansour, J. P., Ichkhanian, Y., Minami, H., Familiari, P., Landi, R., Costamagna, G., Seewald, S., Callahan, Z. M., Ujiki, M. B., Pioche, M., Ponchon, T., Roman, S., Cho, J. Y., Yoo, I. K., Sippey, M., Marks, J. M., Eleftheriadis, N., Khumbari, V., Gutierrez, O. I. B., Khashab, M. A., Durability of per-oral endoscopic myotomy beyond 6 years, <<ENDOSCOPY INTERNATIONAL OPEN>>, 2021; 9 (11): E1595-E1601. [doi:10.1055/a-1553-9846] [https://hdl.handle.net/10807/229454]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/229454
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