Evidence map›Paper›PMID 27858209›Full record

ArticleSurgical endoscopy2017

Outcomes in patients with over 1-year follow-up after peroral endoscopic myotomy (POEM).

Marc A Ward, Matt Gitelis, Lava Patel, Yalini Vigneswaran, Joann Carbray, Michael B Ujiki

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

12 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. 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 · 2020
    Pooled it
  4. Review
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  6. Review
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  8. Article
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  11. Using Impedance Planimetry (EndoFLIP) to Evaluate Myotomy and Predict Outcomes After Surgery for Achalasia.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020
    Article
  12. Gastroparesis managed with peroral endoscopic pyloromyotomy.Proceedings (Baylor University. Medical Center) · 2020
    Article
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

6 authors.

Marc A WardDepartment of Surgery, University of Chicago, 2523 N. California Ave. Apt 3, Chicago, IL, 60647, USA. marcward314@gmail.com.
Matt GitelisDepartment of Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
Lava PatelDepartment of Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
Yalini VigneswaranDepartment of Surgery, University of Chicago, 2523 N. California Ave. Apt 3, Chicago, IL, 60647, USA.
Joann CarbrayDepartment of Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
Michael B UjikiDepartment of Surgery, University of Chicago, 2523 N. California Ave. Apt 3, Chicago, IL, 60647, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeroral endoscopic myotomy (POEM) is a promising therapy in the treatment of achalasia. The study was designed to report outcomes, including quality of life, in patients with at least 1-year follow-up.

methodsPatients from an institutional review board-approved protocol underwent POEM and were followed prospectively. Health-related quality of life was measured preoperatively and 1 year post-operatively using Short Form-36 Health Survey version 2 (SF-36v2). Comparisons were made with patients from a prospective database who underwent laparoscopic Heller myotomy (LHM) over the same period. Paired t tests were used to analyze all normally distributed data, while Wilcoxon signed-rank tests were used to analyze SF-36 data, as it does not follow a normal distribution.

resultsWe analyzed 41 consecutive POEM patients with at least 1-year follow-up. Significant improvements in quality of life between baseline and 1 year were found in role limitations due to physical health (81.8 ± 25.8 vs. 65.9 ± 31.6, p = 0.01) and social functioning (83 ± 19.1 vs. 64.6 ± 31.3, p = 0.01). When compared to 24 patients who underwent LHM, there was no difference in average Eckardt scores (0.9 ± 1.6 vs. 1.0 ± 1.3, p > 0.05) or incidence of PPI use (43.5 vs. 47.5 %, p = 0.71). However, when looking at just type III patients, POEM patients had a higher remission rate (100 vs. 62.5 %) and significantly lower post-operative Eckardt scores at 1 year (1.1 vs. 3.1, p < 0.05). The average myotomy length of type III achalasia patients undergoing POEM was 18.6 cm (±6.9) compared to 10.3 cm (±1.0) in LHM patients (p < 0.01), which may have contributed to this difference.

conclusionPOEM provides a significant quality of life benefit at 1 year while having similar relief of dysphagia and post-operative PPI use compared to LHM. Type III achalasia patients may have better outcomes with POEM compared to LHM.

Indexed as

EsophagoscopyLaparoscopyDatabases, FactualEsophageal AchalasiaFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedPostoperative PeriodProspective StudiesQuality of LifeTreatment OutcomeAchalasiaEckardt scoreLaparoscopic Heller myotomyPeroral endoscopic myotomy (POEM)Type III achalasia

Identifiers

PMID27858209

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.