Abstract:
AIM:To compare long-term occurrence of gastroesophageal reflux disease (GERD) between two different types of peroral endoscopic myotomy (POEM) for achalasia. METHODS:We included all patients with achalasia who underwent POEM at our hospital from August 2011 to October 2012 and had complete GERD evaluation with ≥ 3 years of follow-up. They were divided into circular or full-thickness myotomy groups according to the depth of myotomy. Demographics, Eckardt score, manometry results, 24-h pH monitoring, and GERD symptoms were recorded and compared between the two groups. RESULTS:We studied 56 patients (32 circular myotomy and 24 full-thickness myotomy) with complete GERD evaluation. There was no significant difference between the two groups in terms of treatment success (defined as Eckardt score ≤ 3), postoperative Eckardt score, mean basal lower esophageal sphincter pressure, and 4-s integrated relaxation pressure (4sIRP). Postoperative abnormal esophageal acid exposure was found in 25 patients (44.6%). A total of 13 patients (23.2%) had GERD symptoms and 12 had esophagitis (21.4%). Clinically relevant GERD (abnormal esophageal acid exposure associated with GERD symptoms and/or esophagitis) was diagnosed in 13 patients (23.2%). Multivariate analysis revealed that full-thickness myotomy and low level of postoperative 4sIRP were predictive factors for clinically relevant GERD. CONCLUSION:Efficacy and manometry are comparable between achalasia patients treated with circular or full-thickness myotomy. But patients with full-thickness myotomy and low postoperative 4sIRP have more GERD.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Wang XH,Tan YY,Zhu HY,Li CJ,Liu DLdoi
10.3748/wjg.v22.i42.9419subject
Has Abstractpub_date
2016-11-14 00:00:00pages
9419-9426issue
42eissn
1007-9327issn
2219-2840journal_volume
22pub_type
杂志文章abstract:AIM:To compare the outcome of upper gastrointestinal bleeding (UGIB) between patients receiving restrictive and liberal transfusion. METHODS:PubMed, EMBASE, and Cochrane Library databases were employed to identify all relevant randomized controlled trials regarding the outcome of UGIB after restrictive or liberal tran...
journal_title:World journal of gastroenterology
pub_type: 杂志文章,meta分析,评审
doi:10.3748/wjg.v19.i40.6919
更新日期:2013-10-28 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2014-07-14 00:00:00
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,多中心研究
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更新日期:2014-05-07 00:00:00
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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更新日期:2014-02-21 00:00:00
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pub_type: 杂志文章
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更新日期:2013-12-28 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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更新日期:2020-09-14 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2009-07-21 00:00:00
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pub_type: 杂志文章
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更新日期:2001-10-01 00:00:00