ArticleSurgical endoscopy2016
Gastroesophageal reflux symptoms do not correlate with objective pH testing after peroral endoscopic myotomy.
Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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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.
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.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Is peroral endoscopic myotomy (POEM) more effective than pneumatic dilation and Heller myotomy? A systematic review and meta-analysis.Surgical endoscopy · 2021Pooled it
- Quality of Life Following Peroral Endoscopic Myotomy for Esophageal Achalasia: A Systematic Review and Meta-Analysis.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2020Pooled it
- Trial
- Trial
- Reflux symptom burden and objective findings at long-term follow-up after peroral endoscopic myotomy.Surgical endoscopy · 2026Article
- Esophageal myotomy and risk of esophageal cancer and mortality in achalasia: Real-world cohort study.Endoscopy international open · 2026Article
- The role of transoral incisionless fundoplication (TIF) in the management of gastroesophageal reflux disease (GERD) following peroral endoscopic myotomy (POEM): A pilot, prospective, patient-driven study.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2024Article
- Clinical and financial outcomes of per-oral endoscopic myotomy compared to laparoscopic heller myotomy for treatment of achalasia.Surgical endoscopy · 2023Article
- Laparoscopic Heller Myotomy with Dor Fundoplication: An Operation that has Withstood the Test of Time.World journal of surgery · 2022Article
- Gastro-esophageal reflux disease (GERD) after peroral endoscopic myotomy (POEM).Surgical endoscopy · 2022Article
- Complex Gastroesophageal Reflux Disease.Gastro hep advances · 2022Review
- POEM: clinical outcomes beyond 5 years.Surgical endoscopy · 2021Article
- Per-oral endoscopic dual myotomy for the treatment of achalasia.Esophagus : official journal of the Japan Esophageal Society · 2021Article
- Intraoperative impedance planimetry (EndoFLIP™) results and development of esophagitis in patients undergoing peroral endoscopic myotomy (POEM).Surgical endoscopy · 2021Article
- The Reflux Symptoms Before and After Peroral Endoscopic Myotomy of Chinese Patients With Achalasia.Journal of neurogastroenterology and motility · 2021Article
- CYP2C19 genotype variability in patients with refractory gastroesophageal reflux after per-oral endoscopic myotomy (POEM).Endoscopy international open · 2021Article
- Observational
- Post-POEM reflux: who's at risk?Surgical endoscopy · 2020Article
- Outcome of peroral endoscopic myotomy in children with achalasia.Surgical endoscopy · 2019Article
- Per-oral endoscopic myotomy and gastroesophageal reflux: Where do we stand after a decade of "POETRY"?Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2019Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPeroral endoscopic myotomy (POEM) is an emerging treatment for esophageal achalasia. Postoperative reflux has been found in a significant number of patients, but it is unknown whether subjective reports of reflux correlate with objective pH testing. The purpose of this study was to compare the objective rate of reflux with standardized reflux symptom scales after POEM. Our hypothesis was that subjective symptoms would not correlate with objective measurement of reflux. METHODS AND PROCEDURES: Data on all patients undergoing POEM were collected prospectively between August 2012 and June 2014 and included demographics, objective testing (48-h pH probe, manometry, endoscopy), as well as gastroesophageal reflux disease health-related quality of life (GERD-HRQL), GERD symptom scale (GERSS), and antacid use.
resultsForty-three patients underwent POEM during the study period. The mean age was 53.5 ± 17.4 years with a BMI of 29.6 ± 8.4 kg/m(2), and 27 (63%) were male. Forty-two patients (98%) completed at least 6 months of follow-up, and 26 (60%) underwent repeat pH measurement. Dysphagia scores improved from 4 (0-5) at baseline to 0 (0-3) (p < 0.001). On follow-up pH testing, 11 (42%) were normal and 15 (58%) had elevated DeMeester scores. Postoperative GERSS or GERD-HRQL scores did not correlate with DeMeester scores on Spearman's rank-order tests (r = 0.02, p = 0.93 and r = 0.04, p = 0.50, respectively). Postoperative PPI use was not significantly associated with normal or abnormal pH testing: 5 of 7 (71%) patients who were taking PPIs postoperatively had abnormal DeMeester scores compared to 9 of 18 (50%) of patients who were not taking PPIs (p = 0.332).
conclusionsPeroral endoscopic myotomy provides excellent dysphagia relief for patients with achalasia, but is associated with a high rate of reflux on pH testing postoperatively. Subjective symptoms are not a reliable indicator of postoperative reflux. Routine pH testing should be considered in all patients following POEM.
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