Comparison of Short Versus Long Esophageal Myotomy in Cases With Idiopathic Achalasia: A Randomized Controlled Trial.

Journal of Neurogastroenterology and Motility
Zaheer NabiD Nageshwar Reddy

Abstract

Per-oral endoscopic myotomy (POEM) is an established treatment for achalasia. The technique of POEM is still evolving and the impact of length of esophageal myotomy on the outcomes of POEM is not known. In this study, we aim to compare the outcomes of short (3 cm) versus long (6 cm and above) esophageal myotomy in patients undergoing POEM for achalasia cardia. Consecutive patients with idiopathic achalasia (type I and II) were randomized to receive short (3 cm) or long esophageal myotomy (≥ 6 cm). Both groups were compared for clinical success, operative time, adverse events, and gastroesophageal reflux disease (GERD). Seventy-one consecutive patients with type I and II achalasia underwent POEM with short (n = 34) or long (n = 37) esophageal myotomy techniques. Mean length of esophageal myotomy in short and long groups was 2.76 ± 0.41 and 7.97 ± 2.40, respectively (P < 0.001). Mean operative time was significantly shorter in short myotomy group (44.03 ± 13.78 minutes and 72.43 ± 27.28 minutes, P < 0.001). Clinical success was comparable in both arms at 1-year (Eckardt score 0.935 ± 0.929 vs 0.818 ± 0.983, P = 0.627). Improvement in objective parameters including integrated relaxation pressure and barium column height at 5 minut...Continue Reading

References

May 14, 2003·Archives of Surgery·Brant K OelschlagerCarlos A Pellegrini
Sep 13, 2014·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·J WangY Cui
Jul 25, 2015·Journal of the American College of Surgeons·Haruhiro InoueShin-ei Kudo
Jan 1, 2016·Journal of Neurogastroenterology and Motility·Young Hoon YounHyojin Park
Apr 7, 2016·Journal of Neurogastroenterology and Motility·Zaheer NabiRadhika Chavan
May 10, 2017·Endoscopy International Open·Zaheer NabiNageshwar Reddy
Oct 11, 2017·Gastrointestinal Endoscopy·Zaheer NabiMohan Ramchandani
Feb 14, 2018·Gut·C Prakash GyawaliSabine Roman
Sep 4, 2019·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Zaheer NabiD Nageshwar Reddy
Sep 29, 2019·Esophagus : Official Journal of the Japan Esophageal Society·Haruhiro InoueHisao Tajiri

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Citations

Jan 1, 2021·Journal of Neurogastroenterology and Motility·Yang Won Min
Mar 21, 2021·Gastrointestinal Endoscopy·Li Gu, Deliang Lu
May 22, 2021·Therapeutic Advances in Gastrointestinal Endoscopy·Elizabeth BrindiseRami El Abiad
Aug 14, 2021·Current Opinion in Gastroenterology·Zaheer Nabi, D Nageshwar Reddy
Sep 2, 2021·Endoscopy International Open·Zaheer NabiNageshwar D Reddy

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Clinical Trials Mentioned

NCT03186248

Software Mentioned

Statistical package for social sciences ( SPSS
POEM

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