Comparison of the safety and efficacy of peroral endoscopic myotomy between octogenarians and non-octogenarians.
Dig Endosc
; 33(1): 110-117, 2021 Jan.
Article
en En
| MEDLINE
| ID: mdl-32274834
ABSTRACT
OBJECTIVES:
This study compared the safety and efficacy of peroral endoscopic myotomy for esophageal motility disorders between octogenarians and non-octogenarians.METHODS:
This retrospective observational study recruited 321 patients (28 octogenarians and 293 non-octogenarians) who underwent peroral endoscopic myotomy from two institutions. Clinical success (postoperative Eckardt score ≤ 3), technical success (completion of gastric and esophageal myotomy), and perioperative adverse events were compared between octogenarians and non-octogenarians. Perioperative adverse events were classified into major and minor adverse events based on the International Peroral Endoscopic Myotomy Survey criteria and were subdivided into technical and non-technical adverse events according to the presence of a direct causal relationship with the procedure.RESULTS:
There were no significant differences in the rates of clinical success 1 year after treatment (100% vs. 97.3%, P = 0.64) and technical success (100% vs. 99.7%, P = 0.91) between octogenarians and non-octogenarians. Octogenarians had a higher incidence of perioperative adverse events (28.6% vs. 10.2%, P = 0.00097), particularly major adverse events (25.0% vs. 3.0%, P < 0.0001). There were no significant differences in the incidence of minor adverse events (7.1% vs. 7.9%, P = 0.67). Although there was no difference in the incidence of technical adverse events (10.7% vs. 9.2%, P = 0.74), octogenarians had a significantly higher incidence of non-technical adverse events (17.9% vs. 1.0%, P = 0.0002).CONCLUSIONS:
There were no significant differences in short-term clinical success and technical success between octogenarians and non-octogenarians. However, octogenarians showed a significantly higher incidence of perioperative adverse events, particularly in major adverse events and non-technical adverse events. Peroral endoscopic myotomy for octogenarians should be carefully applied.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Acalasia del Esófago
/
Cirugía Endoscópica por Orificios Naturales
/
Miotomía
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Aged80
/
Humans
Idioma:
En
Revista:
Dig Endosc
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Japón