Factors associated with early failure of peroral endoscopic myotomy in achalasia.
Gastrointest Endosc
; 99(3): 349-357.e3, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-37806398
ABSTRACT
BACKGROUND AND AIMS:
Achalasia can be treated very effectively with peroral endoscopic myotomy (POEM), but factors associated with early failure remain to be determined, especially in European cohorts.METHODS:
All consecutive adult patients who underwent a first POEM to treat primary achalasia were included in this multicenter retrospective study. Early failure was defined by an Eckardt score (ES) >3 at 3 months after POEM. When evaluating factors predictive of early failure, 2 cohorts were considered one consisted of the total population, for whom only basic variables were collected, and the other a cohort built for a case-control study that included matched early-failure and early-success patients (ratio, 12).RESULTS:
Among 746 patients, the early failure rate was 9.4%. Predictive factors were age ≤45 years (P = .019), achalasia types I and III (P < .001), and the development of a severe adverse event during the procedure (P = .023). In the case-control study, the only additional independent risk factor for early failure was a high pre-POEM ES (P = .001). Only the retrosternal pain subscore was significantly associated with the early failure rate.CONCLUSION:
The early failure rate of POEM used to treat primary achalasia is <10%. Younger age, type I/III achalasia, and a high pre-POEM ES were significantly associated with failure.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Acalasia Esofágica
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Cirurgia Endoscópica por Orifício Natural
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Miotomia
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article