Thijs Kuipers, F. A. Ponds, Paul Fockens, B. Bastiaansen, J. Pandolfino, A. Bredenoord
{"title":"Focal distal esophageal dilation (blown-out myotomy) after achalasia treatment: prevalence and associated symptoms.","authors":"Thijs Kuipers, F. A. Ponds, Paul Fockens, B. Bastiaansen, J. Pandolfino, A. Bredenoord","doi":"10.14309/ajg.0000000000002816","DOIUrl":null,"url":null,"abstract":"METHODS\nA dataset of the locally treated patients in a randomized controlled trial comparing POEM with pneumatic dilation (PD) was analyzed. A BOM is defined as a >50% increase in esophageal diameter at its widest point in the distal esophagus between the lower esophageal sphincter and 5 cm above.\n\n\nRESULTS\n74 patients were treated in our center, 5-year follow-up data was available in 55 patients (32 (58%) patients randomized to POEM, 23 (42%) PD). In the group initially treated with POEM the incidence of BOM increased from 11.5% (4/38) at three months, 21.1% (8/38) at 1 year, 27.8% (10/36) at 2 years and 31.3% (10/32) at 5 years. None of the patients treated with PD alone developed a BOM. Patients that developed a BOM had higher total Eckardt score and Eckardt regurgitation component compared to patients that underwent POEM without BOM development (3 (2.75-3.25) vs 2 (1.75-3) p=0.032) and (1 (0.75-1 vs 0 (0-1) p=0.041). POEM patients with a BOM more often report reflux symptoms (85% (11/13) vs 46% (2/16), p=0.023) and had a higher acid exposure time ((24.5% (8-47)) vs 6% (1.2-18.7), p=0.027).\n\n\nCONCLUSION\n30% of the patients treated with POEM develop a BOM, which is associated with a higher acid exposure, more reflux symptoms and symptoms of regurgitation.","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The American Journal of Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14309/ajg.0000000000002816","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
METHODS
A dataset of the locally treated patients in a randomized controlled trial comparing POEM with pneumatic dilation (PD) was analyzed. A BOM is defined as a >50% increase in esophageal diameter at its widest point in the distal esophagus between the lower esophageal sphincter and 5 cm above.
RESULTS
74 patients were treated in our center, 5-year follow-up data was available in 55 patients (32 (58%) patients randomized to POEM, 23 (42%) PD). In the group initially treated with POEM the incidence of BOM increased from 11.5% (4/38) at three months, 21.1% (8/38) at 1 year, 27.8% (10/36) at 2 years and 31.3% (10/32) at 5 years. None of the patients treated with PD alone developed a BOM. Patients that developed a BOM had higher total Eckardt score and Eckardt regurgitation component compared to patients that underwent POEM without BOM development (3 (2.75-3.25) vs 2 (1.75-3) p=0.032) and (1 (0.75-1 vs 0 (0-1) p=0.041). POEM patients with a BOM more often report reflux symptoms (85% (11/13) vs 46% (2/16), p=0.023) and had a higher acid exposure time ((24.5% (8-47)) vs 6% (1.2-18.7), p=0.027).
CONCLUSION
30% of the patients treated with POEM develop a BOM, which is associated with a higher acid exposure, more reflux symptoms and symptoms of regurgitation.