Evidence map›Paper›PMID 24939164›Full record

Trial reportSurgical endoscopy2014

Symptomatic and physiologic outcomes one year after peroral esophageal myotomy (POEM) for treatment of achalasia.

Ezra N Teitelbaum, Nathaniel J Soper, Byron F Santos, Fahd O Arafat, John E Pandolfino, Peter J Kahrilas, Ikuo Hirano, Eric S Hungness

Abstract readClinical Trial
PubMed Publisher
In one paragraph

Trial report in Surgical endoscopy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 4 pooled it
14.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 113 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Article
  8. PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2023
    Observational
  9. Updates in the Field of Submucosal Endoscopy.Life (Basel, Switzerland) · 2022
    Review
  10. Observational
  11. Article
  12. Article
  13. Article
  14. Article
  15. Peroral endoscopic myotomy (POEM) for achalasia.Journal of thoracic disease · 2019
    Review
  16. Review
  17. Treatment of Idiopathic Achalasia with Per-Oral Esophageal Myotomy.Techniques in gastrointestinal endoscopy · 2018
    Article
  18. POEM in the Treatment of Esophageal Disorders.Current treatment options in gastroenterology · 2018
    Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Ezra N TeitelbaumDepartment of Surgery, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Chicago, IL, 60611, USA, ezratei@gmail.com.
Nathaniel J Soper
Byron F Santos
Fahd O Arafat
John E Pandolfino
Peter J Kahrilas
Ikuo Hirano
Eric S Hungness
Northwestern University · USDartmouth–Hitchcock Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeroral esophageal myotomy (POEM) is a new endoscopic operation for the treatment of achalasia. Here, we report 1-year physiologic and symptomatic outcomes following the procedure.

methodsPOEM patients from a single-institution series who were more than 1 year removed from surgery were studied. Eckardt and GerdQ scores were obtained to assess symptoms. High-resolution manometry (HRM), timed barium esophagram (TBE), and upper endoscopy were preformed preoperatively and at 1-year follow-up. 24-h pH monitoring was also performed at 1 year follow-up.

resultsThe study population was comprised of 41 patients who were more than 1 year post-POEM. One (2%) major complication, a contained leak at the EGJ requiring re-operation, and 7 (17%) minor complications occurred. Mean length of stay was 1.4 days. At mean 15-month follow-up, Eckardt scores improved from pre-POEM 7 ± 2 to post-POEM 1 ± 2, (scale 0-12, p < .001), and 92% of patients achieved treatment success (Eckardt score <4). Two of the three treatment failures in the series occurred in the initial three patients. 15% of patients had post-POEM symptoms suggestive of gastroesophageal reflux (GerdQ >7). On follow-up HRM, esophagogastric junction integrated relaxation pressure was decreased significantly (pre-POEM 28 ± 12 mmHg vs. post-POEM 11 ± 4 mmHg, p < .001), and 47% of patients studied had partial recovery of peristalsis. On follow-up TBE, barium column heights were decreased compared with preoperatively. Postoperative upper endoscopy revealed esophagitis in 59% of patients (11 LA Grade A, 2 LA Grade D). However, of the 13 24-h pH monitoring studies performed, only four (31%) demonstrated pathologic esophageal acid exposure.

conclusionsIn this series, POEM resulted in greater than 90% symptomatic treatment success at mean 15-month follow-up. Rates of iatrogenic gastroesophageal reflux, as measured both by symptoms and 24-h pH monitoring, appeared to be on par with recent studies of patients undergoing laparoscopic Heller myotomy and pneumatic dilation.

Indexed as

AdolescentAdultAgedAged, 80 and overEsophageal AchalasiaEsophagogastric JunctionFemaleFollow-Up StudiesHumansLength of StayMaleManometryMiddle AgedNatural Orifice Endoscopic SurgeryPostoperative ComplicationsProspective Studies

Identifiers

PMID24939164
OpenAlexW2019823920

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.