An "esophageal rosette" sign is useful for predicting favorable outcomes in peroral endoscopic myotomy for esophageal achalasia.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Esophagus Pub Date : 2024-11-22 DOI:10.1007/s10388-024-01098-0

Kazutoshi Higuchi, Osamu Goto, Noriyuki Kawami, Eri Momma, Yoshimasa Hoshikawa, Shintaro Hoshino, Masahiro Niikawa, Shun Nakagome, Tsugumi Habu, Keiichiro Yoshikata, Yumiko Ishikawa, Eriko Koizumi, Kumiko Kirita, Hiroto Noda, Takeshi Onda, Jun Omori, Naohiko Akimoto, Katsuhiko Iwakiri

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Abstract

Background: An "esophageal rosette" (ER) sign is one of the endoscopic findings in primary esophageal achalasia. We investigated whether ER was associated with the therapeutic efficacy of peroral endoscopic myotomy (POEM).

Methods: The clinical characteristics and short-term outcomes of POEM were retrospectively evaluated in 69 patients who underwent the procedure for esophageal achalasia. The patients were divided into two groups according to the presence of an ER sign (ER and non-ER groups). Clinical success was defined as the post-POEM Eckardt score of three or less.

Results: On preoperative endoscopy, 55 (79.7%) patients exhibited ER. The patients in the ER group had a longer disease duration than those in the non-ER group (7.4 vs. 2.7 years, P = 0.0011), although the Eckardt scores before POEM were similar between the two groups. No differences were observed in POEM outcomes between the two groups, including procedure time, length of myotomy, hospital stay, and adverse events. The clinical success of POEM was more frequent in the ER group than in the non-ER group (96.2% vs. 78.6%, P = 0.027). Although the changes in the total Eckardt score and integrated relaxation pressure did not differ between the two groups, dysphagia in the Eckardt score significantly improved in the ER group.

Conclusions: The data suggest that POEM for esophageal achalasia with ER could lead to favorable therapeutic outcomes, particularly dysphagia. The presence of ER may help determine the optimal treatment for esophageal achalasia.

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食管玫瑰征 "有助于预测经口内窥镜肌切开术治疗食管贲门失弛缓症的良好疗效。

背景：食管玫瑰征（ER）是原发性食管贲门失弛缓症的内镜检查结果之一。我们研究了ER是否与口周内镜下肌切开术（POEM）的疗效有关：方法：我们对 69 名因食道贲门失弛缓症而接受 POEM 手术的患者的临床特征和短期疗效进行了回顾性评估。根据ER征象的存在将患者分为两组（ER组和非ER组）。临床成功的定义是术后 Eckardt 评分达到或低于 3 分：在术前内镜检查中，55 例（79.7%）患者出现 ER 征。ER组患者的病程比非ER组长（7.4年对2.7年，P = 0.0011），但两组患者在POEM前的Eckardt评分相似。两组患者的 POEM 结果（包括手术时间、肌切开术时间、住院时间和不良事件）无差异。与非 ER 组相比，ER 组的 POEM 临床成功率更高（96.2% 对 78.6%，P = 0.027）。虽然两组患者的埃卡特总评分和综合松弛压的变化没有差异，但ER组患者的埃卡特评分中的吞咽困难明显改善：数据表明，对伴有ER的食管失弛缓症进行POEM治疗可获得良好的治疗效果，尤其是吞咽困难。ER的存在有助于确定食道贲门失弛缓症的最佳治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Esophagus GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.90

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.