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.
Other formats:   BibTeX LaTeX RIS
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
Original language English
Type of outcome Article in a journal
Field of Study 30212 Surgery
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
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
Tags 14119612, EL OK, rivok
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 10/2/2019 17:20.
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 <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.
PrintDisplayed: 20/7/2024 07:26