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Peroral endoscopic myotomy as salvation technique post-Heller: International experience.
- Source :
- Digestive Endoscopy; Jan2018, Vol. 30 Issue 1, p52-56, 5p
- Publication Year :
- 2018
-
Abstract
- Background Treatment for achalasia has traditionally been Heller myotomy (HM). Despite its excellent efficacy rate, a number of patients remain symptomatic post-procedure. Limited data exist as to the best management for recurrence of symptoms post-HM. We present an international, multicenter experience evaluating the efficacy and safety of post-HM peroral endoscopic myotomy (POEM). Methods Patients who underwent POEM post-HM from 13 centers from January 2012 to January 2017 were included as part of a prospective registry. Technical success was defined as successful completion of the myotomy. Clinical success was defined as an Eckardt score of ≤3 on 12-month follow up. Adverse events (AE) including anesthesia-related, operative, and postoperative complications were recorded. Results Fifty-one patients were included in the study (mean age 54.2, 47% male). Technical success was achieved in 100% of patients. Clinical success on long-term follow up was achieved in 48 patients (94%), with a mean change in Eckardt score of 6.25. Seven patients (13%) had AE: six experienced periprocedural mucosal defect treated endoscopically and two patients developed mediastinitis treated conservatively. Conclusion For patients with persistent symptoms after HM, POEM is a safe salvation technique with good short-term efficacy. As a result of the challenge associated with repeat HM, POEM might become the preferred technique in this patient population. Further studies with longer follow up are needed. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09155635
- Volume :
- 30
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Digestive Endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 127490975
- Full Text :
- https://doi.org/10.1111/den.12918