Mid-Term and Long-Term Outcomes of Peroral Endoscopic Myotomy for the Treatment of Achalasia: A Systematic Review and Meta-Analysis

Zhang, Han; Zeng, Xinyi; Huang, Shu; Shi, Lei; Xia, Huifang; Jiang, Jiao; Ren, Wensen; Peng, Yan; Lü, Muhan; Tang, Xiaowei

doi:10.1007/s10620-022-07720-4

Cited by 14 publications

(7 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In terms of long‐term efficacy, POEM was similarly reported to be safe and highly effective, with >90% clinical success at >5 years in a longitudinal study of 610 patients in the USA, and the efficacy was further demonstrated in subsequent meta‐analyses (Table 3). 70–72 In a network meta‐analysis, POEM was ranked first among the treatment strategies, however not significantly more effective than HM 67 . However, because of the feasibility of a longer myotomy, POEM has been shown to be better than HM in achieving symptomatic relief for type III achalasia (98.0% vs 80.8%, P = 0.01) 23 …”

Section: Resultsmentioning

confidence: 99%

Malaysian joint societies' consensus recommendations on diagnosis and management of disorders of esophagogastric junction outflow

Chuah,

Ramasami,

Mahendran

et al. 2023

J of Gastro and Hepatol

View full text Add to dashboard Cite

Disorders of esophagogastric junction (EGJ) outflow, including achalasia and EGJ outflow obstruction, are motility disorders characterized by inadequate relaxation of lower esophageal sphincter with or without impaired esophageal peristalsis. Current guidelines are technical and less practical in the Asia–Pacific region, and there are still massive challenges in timely diagnosis and managing these disorders effectively. Therefore, a Malaysian joint societies' task force has developed a consensus on disorders of EGJ outflow based on the latest evidence, while taking into consideration the practical relevance of local and regional context and resources. Twenty‐one statements were established after a series of meetings and extensive review of literatures. The Delphi method was used in the consensus voting process. This consensus focuses on the definition, diagnostic investigations, the aims of treatment outcome, non‐surgical or surgical treatment options, management of treatment failure or relapse, and the management of complications. This consensus advocates the use of high‐resolution esophageal manometry for diagnosis of disorders of EGJ outflow. Myotomy, via either endoscopy or laparoscopy, is the preferred treatment option, while pneumatic dilatation can serve as a secondary option. Evaluation and management of complications including post‐procedural reflux and cancer surveillance are recommended.

show abstract

Section: Resultsmentioning

confidence: 99%

Malaysian joint societies' consensus recommendations on diagnosis and management of disorders of esophagogastric junction outflow

Chuah,

Ramasami,

Mahendran

et al. 2023

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…More than three thousand authors have conducted studies on POEM in treating achalasia. Among them, the top ten by the number of publications were Inoue Haruhiro (72), Khashab Mouen A (41), Nabi Zaheer (31), Pandolfino John E (29), Onimaru Manabu (26), Ramchandani Mohan (24), Patti Marco G (22), Sato Hiroki ( 22), Li Quan-Lin (20), and Hungness, Eric S (20) (Figure 5A). The author who published the most articles was Inoue Haruhiro from Showa University in Japan.…”

Section: Author Analysismentioning

confidence: 99%

A bibliometric analysis of peroral endoscopic myotomy for achalasia: Where have we been and where should we go next?

Zhang

2023

Japanese J Gastroenterol Res

View full text Add to dashboard Cite

show abstract

“…Clinical success (Eckardt score ≤3) is achieved in 80%-91.9% of the patients after 5 years of follow-up. [6][7][8][9][10] POEM is a minimally invasive procedure in which the LES is cut endoscopically to improve esophageal emptying. By disrupting the LES, the anti-reflux barrier between the esophagus and the stomach is also affected.…”

Section: Introductionmentioning

confidence: 99%

“…Previous systematic reviews have concluded that pooled rates of reflux complaints, reflux esophagitis and abnormal acid exposure after POEM were 8.5%-37%, 3.7%-33%, and 47%-48%, respectively. [10][11][12][13] Reflux esophagitis after POEM is usually graded as mild according to the Los Angeles (LA) classification and seems to diminish over time 14 Usually, reflux esophagitis after POEM is well controlled with proton-pump inhibitors and does not need additional endoscopic or surgical intervention. 15 Up to now, little is known about which factors predict the development of reflux esophagitis after POEM.…”

Section: Introductionmentioning

confidence: 99%

“…Since the first POEM was carried out in 2007, 5 there is a growing body of evidence showing high long‐term efficacy rates of POEM. Clinical success (Eckardt score ≤3) is achieved in 80%–91.9% of the patients after 5 years of follow‐up 6–10 . POEM is a minimally invasive procedure in which the LES is cut endoscopically to improve esophageal emptying.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence and risk factors of reflux esophagitis after peroral endoscopic myotomy

Wessels,

Masclee,

Bastiaansen

et al. 2024

Neurogastroenterology Motil

View full text Add to dashboard Cite

BackgroundPeroral endoscopic myotomy (POEM) is an effective and safe treatment for achalasia, but often leads to posttreatment gastroesophageal reflux disease. The aim of this study was to examine the incidence and severity of reflux esophagitis after POEM and to identify associated predictive factors.MethodsPatients who underwent POEM between August 2011 and December 2022 were included. Multivariate logistic regression was used to assess predictive factors for reflux esophagitis after POEM.Key ResultsIn total, 252 patients were included; of which, 46% were female and age ranged between 18 and 87 years. Reflux esophagitis within 1 year after POEM was observed in 131 patients (52%), which was severe in 29 patients (LA grade C/D, 12%). Length of full‐thickness myotomy (cm; OR 1.11, 95% CI 1.02–1.21), Eckardt scores before POEM (OR 0.84, 95% CI 0.74–0.96), previous pneumatic dilation (OR 0.51, 95% CI 0.29–0.91), and previous laparoscopic Heller myotomy (LHM; OR 0.44, 95% CI 0.23–0.86) were associated with reflux esophagitis after POEM. Alcohol use (none vs > 7 units per week; OR 3.51, 95% CI 1.35–9.11) and overweight (BMI ≥25 kg/m2; OR 2.67, 95% CI 1.17–6.09) were positive predictive factors and previous LHM (OR 0.13, 95% CI 0.02–0.95) was a negative predictive factor for severe reflux esophagitis after POEM (LA grade C/D).ConclusionAbout half of the patients develop reflux esophagitis after POEM and 12% is graded as severe. Recognizing predictive factors of reflux esophagitis after POEM treatment leads to better patient selection before POEM and provides an opportunity to take preventive measures or start preemptive treatment.

show abstract

Mid-Term and Long-Term Outcomes of Peroral Endoscopic Myotomy for the Treatment of Achalasia: A Systematic Review and Meta-Analysis

Cited by 14 publications

References 41 publications

Malaysian joint societies' consensus recommendations on diagnosis and management of disorders of esophagogastric junction outflow

Malaysian joint societies' consensus recommendations on diagnosis and management of disorders of esophagogastric junction outflow

A bibliometric analysis of peroral endoscopic myotomy for achalasia: Where have we been and where should we go next?

Incidence and risk factors of reflux esophagitis after peroral endoscopic myotomy

Contact Info

Product

Resources

About