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01-10-2021 | Dysphagia | 2020 SAGES Oral

POEM: clinical outcomes beyond 5 years

Authors: Sarah C. McKay, Christy M. Dunst, Ahmed M. Sharata, Reid Fletcher, Kevin M. Reavis, Daniel Davila Bradley, Steven R. DeMeester, Dolores Müller, Brett Parker, Lee L. Swanström

Published in: Surgical Endoscopy | Issue 10/2021

Abstract

Background

The short-term success of peroral endoscopic myotomy (POEM) is well documented but the durability of the operation is questioned. The aim of this study was to evaluate the clinical outcomes of the POEM procedure for esophageal motility disorders in a large cohort in which all patients had at least 5 years of follow-up.

Methods

All patients from a single center who underwent a POEM between October 2010 and September 2014 were followed for long-term clinical outcomes. Postoperative Eckardt symptom scores of short term and ≥ 5 years were collected through phone interview. Clinical success was defined as an Eckardt score < 3. Overall success was defined as Eckardt score < 3 and freedom from additional interventions.

Results

Of 138 patients, 100 patients were available for follow-up (mean age 56, 52% male). The indication for operation was achalasia in 94. The mean follow-up duration was 75 months (range: 60–106 months). Dysphagia was improved in 91% of patients. Long-term overall success was achieved in 79% of patients (80% of achalasia patients, 67% of DES patients). Preoperative mean Eckardt score was 6. At 6 months, it was 1, and at 75 months, it was 2 (p = 0.204). Five-year freedom from intervention was 96%. Overall, 7 patients had additional treatments: 1 balloon dilation (35 mm), 4 laparoscopic Heller myotomy, and 2 redo POEM at a mean of 51 months post-POEM. Ninety-three percent expressed complete satisfaction with POEM.

Conclusion

A multitude of studies has shown the early benefits of POEM. Here, we show that nearly 80% of patients report clinical success with no significant decrement in symptom scores between their short- and long-term follow-up. Clearly POEM is an effective option for achalasia with durable long-term treatment efficacy.

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Title: POEM: clinical outcomes beyond 5 years
Authors: Sarah C. McKay
Christy M. Dunst
Ahmed M. Sharata
Reid Fletcher
Kevin M. Reavis
Daniel Davila Bradley
Steven R. DeMeester
Dolores Müller
Brett Parker
Lee L. Swanström
Publication date: 01-10-2021
Publisher: Springer US
Keywords: Dysphagia
Dysphagia
Achalasia
Dysphagia
Published in: Surgical Endoscopy / Issue 10/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-08031-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

POEM: clinical outcomes beyond 5 years

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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