Hironari Shiwaku1, Haruhiro Inoue2, Hiroki Sato3, Manabu Onimaru2, Hitomi Minami4, Shinwa Tanaka5, Chiaki Sato6, Ryo Ogawa7, Norihiko Okushima8, Hiroshi Yokomichi9. 1. Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan. 2. Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan. 3. Division of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, Niigata, Japan. 4. Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan. 5. Department of Gastroenterology, Kobe University Hospital, Hyogo, Japan. 6. Department of Surgery, Tohoku University School of Medicine, Miyagi, Japan. 7. Department of Gastroenterology, Oita University Faculty of Medicine, Oita, Japan. 8. Heart Life Hospital, Okinawa, Japan. 9. Division of Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, Yamanashi, Japan.
Abstract
BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is an available treatment modalities for achalasia. The reported efficacy of POEM in the only prospective multicenter study was 82%; however, a retrospective multicenter study in Japan reported a higher efficacy rate of 95%. The aim of this study was to prospectively verify treatment outcomes after POEM at multiple facilities in Japan. METHODS: This was a prospective single-arm trial of POEM for achalasia at 8 facilities in Japan between April 2016 and March 2018 to evaluate its safety and efficacy. Patients were re-evaluated at 3 months and up to 1 year after POEM. RESULTS: Among the 233 patients with achalasia who underwent POEM, procedure-related adverse events occurred in 24 patients (10.3%), none of whom required surgical intervention. In the 207 patients satisfying the inclusion criteria, the efficacy rate of POEM, defined by an Eckardt score ≤3 at 1 year, was 97.4% (95% CI, 95.3%-99.7%). The Eckardt score decreased significantly from 6.6 ± 2.0 preoperatively to 1.1 ± 1.1, 1 year after POEM. Postoperative reflux esophagitis, severe reflux esophagitis, and symptomatic GERD were reported in 54.2%, 5.6%, and 14.7%, respectively, and proton pump inhibitors were administered in 21.1%. CONCLUSIONS: Our prospective multicenter study in Japan showed greater efficacy of POEM for achalasia compared with the results of a previous prospective multicenter study. POEM is safe and highly effective for at least 1 year. (Clinical trial registration number: UMIN 000021550.).
BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is an available treatment modalities for achalasia. The reported efficacy of POEM in the only prospective multicenter study was 82%; however, a retrospective multicenter study in Japan reported a higher efficacy rate of 95%. The aim of this study was to prospectively verify treatment outcomes after POEM at multiple facilities in Japan. METHODS: This was a prospective single-arm trial of POEM for achalasia at 8 facilities in Japan between April 2016 and March 2018 to evaluate its safety and efficacy. Patients were re-evaluated at 3 months and up to 1 year after POEM. RESULTS: Among the 233 patients with achalasia who underwent POEM, procedure-related adverse events occurred in 24 patients (10.3%), none of whom required surgical intervention. In the 207 patients satisfying the inclusion criteria, the efficacy rate of POEM, defined by an Eckardt score ≤3 at 1 year, was 97.4% (95% CI, 95.3%-99.7%). The Eckardt score decreased significantly from 6.6 ± 2.0 preoperatively to 1.1 ± 1.1, 1 year after POEM. Postoperative reflux esophagitis, severe reflux esophagitis, and symptomatic GERD were reported in 54.2%, 5.6%, and 14.7%, respectively, and proton pump inhibitors were administered in 21.1%. CONCLUSIONS: Our prospective multicenter study in Japan showed greater efficacy of POEM for achalasia compared with the results of a previous prospective multicenter study. POEM is safe and highly effective for at least 1 year. (Clinical trial registration number: UMIN 000021550.).
Authors: Dagmar Simkova; Jan Mares; Zuzana Vackova; Tomas Hucl; Petr Stirand; Eva Kieslichova; Ondrej Ryska; Julius Spicak; Sylvia Drazilova; Eduard Veseliny; Jan Martinek Journal: Surg Endosc Date: 2022-09-28 Impact factor: 3.453
Authors: Jennifer M Kolb; Daniel Jonas; Mateus Pereira Funari; Hazem Hammad; Paul Menard-Katcher; Mihir S Wagh Journal: World J Gastrointest Endosc Date: 2020-12-16