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

J 2018

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

MARTINEK, Jan, Hana SVECOVA, Zuzana VACKOVA, Radek DOLEZEL, Ondřej NGO et. al.

Basic information

Original name

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

Authors

MARTINEK, Jan (203 Czech Republic, guarantor), Hana SVECOVA (203 Czech Republic), Zuzana VACKOVA (203 Czech Republic), Radek DOLEZEL (203 Czech Republic), Ondřej NGO (203 Czech Republic, belonging to the institution), Jana KRAJCIOVA (203 Czech Republic), Eva KIESLICHOVA (203 Czech Republic), Radek JANOUSEK (203 Czech Republic), Alexander PAZDRO (203 Czech Republic), Tomas HARUSTIAK (203 Czech Republic), Lucie ZDRHOVA (203 Czech Republic), Pavla LOUDOVA (203 Czech Republic), Petr STIRAND (203 Czech Republic) and Julius SPICAK (203 Czech Republic)

Edition

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, NEW YORK, SPRINGER, 2018, 0930-2794

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 3.209

RIV identification code

RIV/00216224:14110/18:00102802

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s00464-017-5807-3

UT WoS

000424654800027

Keywords in English

Per-oral endoscopic myotomy; Achalasia; Gastroesophageal reflux

Abstract

V originále

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 <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 < 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.

Citovat

MARTINEK, Jan, Hana SVECOVA, Zuzana VACKOVA, Radek DOLEZEL, Ondřej NGO, Jana KRAJCIOVA, Eva KIESLICHOVA, Radek JANOUSEK, Alexander PAZDRO, Tomas HARUSTIAK, Lucie ZDRHOVA, Pavla LOUDOVA, Petr STIRAND and Julius SPICAK. Per-oral endoscopic myotomy (POEM): mid-term efficacy and safety. SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES. NEW YORK: SPRINGER, 2018, vol. 32, No 3, p. 1293-1302. ISSN 0930-2794. Available from: https://dx.doi.org/10.1007/s00464-017-5807-3.

@article{1418470,
   author = {Martinek, Jan and Svecova, Hana and Vackova, Zuzana and Dolezel, Radek and Ngo, Ondřej and Krajciova, Jana and Kieslichova, Eva and Janousek, Radek and Pazdro, Alexander and Harustiak, Tomas and Zdrhova, Lucie and Loudova, Pavla and Stirand, Petr and Spicak, Julius},
   article_location = {NEW YORK},
   article_number = {3},
   doi = {http://dx.doi.org/10.1007/s00464-017-5807-3},
   keywords = {Per-oral endoscopic myotomy; Achalasia; Gastroesophageal reflux},
   language = {eng},
   issn = {0930-2794},
   journal = {SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES},
   title = {Per-oral endoscopic myotomy (POEM): mid-term efficacy and safety},
   volume = {32},
   year = {2018}
}

TY  - JOUR
ID  - 1418470
AU  - Martinek, Jan - Svecova, Hana - Vackova, Zuzana - Dolezel, Radek - Ngo, Ondřej - Krajciova, Jana - Kieslichova, Eva - Janousek, Radek - Pazdro, Alexander - Harustiak, Tomas - Zdrhova, Lucie - Loudova, Pavla - Stirand, Petr - Spicak, Julius
PY  - 2018
TI  - Per-oral endoscopic myotomy (POEM): mid-term efficacy and safety
JF  - SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
VL  - 32
IS  - 3
SP  - 1293-1302
EP  - 1293-1302
PB  - SPRINGER
SN  - 09302794
KW  - Per-oral endoscopic myotomy
KW  - Achalasia
KW  - Gastroesophageal reflux
N2  - 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 <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 < 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.
ER  -

MARTINEK, Jan, Hana SVECOVA, Zuzana VACKOVA, Radek DOLEZEL, Ondřej NGO, Jana KRAJCIOVA, Eva KIESLICHOVA, Radek JANOUSEK, Alexander PAZDRO, Tomas HARUSTIAK, Lucie ZDRHOVA, Pavla LOUDOVA, Petr STIRAND and Julius SPICAK. Per-oral endoscopic myotomy (POEM): mid-term efficacy and safety. \textit{SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES}. NEW YORK: SPRINGER, 2018, vol.~32, No~3, p.~1293-1302. ISSN~0930-2794. Available from: https://dx.doi.org/10.1007/s00464-017-5807-3.

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