Open Access

Influence of esophageal morphology on the clinical efficacy of peroral endoscopic myotomy in treating advanced achalasia cardia

  • Authors:
    • Dan Liu
    • Yue-Yuan Liu
    • Jia-Xin Chen
    • Lei Song
    • Yang-Yang Zhou
    • Saif Ullah
    • Li-Xia Zhao
    • Bin Hai
    • Qing-Fen Zheng
    • Dong-Ying Li
    • De-Zhi He
    • Bing-Rong Liu
  • View Affiliations

  • Published online on: January 8, 2021     https://doi.org/10.3892/etm.2021.9629
  • Article Number: 196
  • Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Peroral endoscopic myotomy (POEM) is the first‑line treatment of achalasia cardia (AC). However, the efficacy of POEM in treating patients with advanced AC remains to be determined. The aim of the present study was to evaluate the feasibility and clinical outcome of POEM in treating patients with advanced AC involving different esophageal morphologies. The study was a single‑center, retrospective analysis of patients suffering from advanced AC. The primary endpoint was the Eckardt score at the follow‑up examination. Secondary endpoints were procedural‑related details, including the operation time and length of myotomy, adverse events (AEs) and hospital stay, as well as post‑procedural gastroesophageal reflux disease. The technical success rate was 100%. All 50 patients enrolled underwent successful endoscopic myotomy (conventional POEM, n=20; modified POEM, n=30). AEs were observed in 10 patients. During a 6‑ to 50‑month follow‑up period, 41 patients achieved clinical success as evidenced by a decrease in the Eckardt score. Only 3 of 6 patients with a sigmoid‑shaped megaesophagus obtained symptomatic relief. Symptomatic reflux occurred in 13 of 46 patients who completed their follow‑up. In conclusion, POEM is safe, feasible and effective in treating advanced AC. Patients with a sigmoid‑shaped megaesophagus are less likely to report palliation of symptoms.
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March-2021
Volume 21 Issue 3

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Copy and paste a formatted citation
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Spandidos Publications style
Liu D, Liu Y, Chen J, Song L, Zhou Y, Ullah S, Zhao L, Hai B, Zheng Q, Li D, Li D, et al: Influence of esophageal morphology on the clinical efficacy of peroral endoscopic myotomy in treating advanced achalasia cardia. Exp Ther Med 21: 196, 2021.
APA
Liu, D., Liu, Y., Chen, J., Song, L., Zhou, Y., Ullah, S. ... Liu, B. (2021). Influence of esophageal morphology on the clinical efficacy of peroral endoscopic myotomy in treating advanced achalasia cardia. Experimental and Therapeutic Medicine, 21, 196. https://doi.org/10.3892/etm.2021.9629
MLA
Liu, D., Liu, Y., Chen, J., Song, L., Zhou, Y., Ullah, S., Zhao, L., Hai, B., Zheng, Q., Li, D., He, D., Liu, B."Influence of esophageal morphology on the clinical efficacy of peroral endoscopic myotomy in treating advanced achalasia cardia". Experimental and Therapeutic Medicine 21.3 (2021): 196.
Chicago
Liu, D., Liu, Y., Chen, J., Song, L., Zhou, Y., Ullah, S., Zhao, L., Hai, B., Zheng, Q., Li, D., He, D., Liu, B."Influence of esophageal morphology on the clinical efficacy of peroral endoscopic myotomy in treating advanced achalasia cardia". Experimental and Therapeutic Medicine 21, no. 3 (2021): 196. https://doi.org/10.3892/etm.2021.9629