Peroral endoscopic myotomy (POEM): a comparative study between Chagasic and idiopathic achalasia
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Tipo de produção
article
Data de publicação
2020
Título da Revista
ISSN da Revista
Título do Volume
Editora
GEORG THIEME VERLAG KG
Citação
ENDOSCOPY INTERNATIONAL OPEN, v.8, n.4, p.E506-E512, 2020
Resumo
Background and study aims Achalasia can be classified as either primary (idiopathic) achalasia or secondary achalasia, which is a consequence of another systemic disease. Peroral endoscopic myotomy (POEM) is an effective and safe treatment for achalasia. We evaluated the efficacy and safety of POEM in patients with Chagasic achalasia compared to idiopathic achalasia. Patients and methods We evaluated POEM procedures performed at a single institution from November 2016 to January 2018. Demographic data, Eckardt score, lower esophageal sphincter (LES) pressure, body mass index, post-operative erosive esophagitis, adverse events, length of hospital stay, and procedure-related parameters were analyzed. Results Fifty-one patients underwent POEM as a treatment for achalasia in this period (20 patients with Chagasic and 31 with Idiopathic etiology). The overall clinical success rate was 92.1 %, with no statistical difference between groups (90 % in the Chagasic group vs. 93.5 % in the Idiopathic group, P = 0.640). Both groups had significant reduction in Eckardt score and in LES pressure, and increase in bodey mass index (BMI) at 1-year follow-up. There was no statistical difference between groups regarding Eckardt score ( P = 0.439), LES pressure (p = 0.507), BMI ( P = 0.254), post erosive esophagitis (35 % vs. 38.7 %, P = 0.789), adverse events (30 % vs. 12 %, P = 0.163,) length of hospital stay (3.75 days vs. 3.58 days, P = 0.622), and operative time (101.3 min vs. 99.1 min, P = 0.840). Conclusion POEM is an effective and safe treatment for patients with achalasia. There is no difference in POEM outcomes for those patients with Chagasic or Idiopathic achalasia.
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Referências
- Barbieri LA, 2015, UNITED EUR GASTROENT, V3, P325, DOI 10.1177/2050640615581732
- Boeckxstaens GE, 2008, AM J GASTROENTEROL, V103, P1610, DOI 10.1111/j.1572-0241.2008.01967.x
- Boeckxstaens GE, 2014, LANCET, V383, P83, DOI 10.1016/S0140-6736(13)60651-0
- Bonifacio P, 2019, DIS ESOPHAGUS, V32, DOI 10.1093/dote/doy105
- Cotton PB, 2010, GASTROINTEST ENDOSC, V71, P446, DOI 10.1016/j.gie.2009.10.027
- DEOLIVEIRA RB, 1995, AM J GASTROENTEROL, V90, P1119
- Eckardt V F, 2001, Gastrointest Endosc Clin N Am, V11, P281
- ECKARDT VF, 1992, GASTROENTEROLOGY, V103, P1732, DOI 10.1016/0016-5085(92)91428-7
- Gao QP, 2017, AM J GASTROENTEROL, V112, pS173, DOI 10.14309/00000434-201710001-00316
- Inoue H, 2010, ENDOSCOPY, V42, P265, DOI 10.1055/s-0029-1244080
- Kahaleh M, 2019, J CLIN GASTROENTEROL, V53, pE352, DOI 10.1097/MCG.0000000000001161
- Khashab MA, 2017, GASTROINTEST ENDOSC, V85, P228, DOI 10.1016/j.gie.2016.06.048
- Lundell LR, 1999, GUT, V45, P172, DOI 10.1136/gut.45.2.172
- Martinek J, 2018, SURG ENDOSC, V32, P1293, DOI 10.1007/s00464-017-5807-3
- Mayberry J F, 2001, Gastrointest Endosc Clin N Am, V11, P235
- Nabi Z, 2018, GASTROINTEST ENDOSC, V87, P4, DOI 10.1016/j.gie.2017.09.029
- Ramchandani M, 2018, J GASTROEN HEPATOL, V33, P1436, DOI 10.1111/jgh.14097
- REYNOLDS JC, 1989, GASTROENTEROL CLIN N, V18, P223
- Rezende JM, 1982, REV GOIANA MED, V28, P187
- Rosner B, 1986, FUNDAMENTALS BIOSTAT, P584
- Spiess AE, 1998, JAMA-J AM MED ASSOC, V280, P638, DOI 10.1001/jama.280.7.638
- Timm N H, 1975, MULTIVARIATE ANAL AP, P687
- TRONCON LEA, 1993, DIGEST DIS SCI, V38, P1511, DOI 10.1007/BF01308613
- Vaezi MF, 2013, AM J GASTROENTEROL, V108, P1238, DOI 10.1038/ajg.2013.196
- Winter H., 2015, British Journal of Medical Practitioners, V8, pa810
- Wu QN, 2017, ENDOSCOPY, V49, P736, DOI 10.1055/s-0043-113440
- Yu L, 2010, DIS ESOPHAGUS, V23, P277, DOI 10.1111/j.1442-2050.2009.01031.x
- Zaninotto G, 2018, DIS ESOPHAGUS, V31, DOI 10.1093/dote/doy071