Evidence map›Paper›PMID 32170414›Full record

ArticleEuropean radiology2020

Meglumine diatrizoate esophagogram after peroral endoscopic myotomy (POEM): identification of imaging findings associated with clinical complications and longer hospital stay.

Maximilien Barret, Anthony Dohan, Ammar Oudjit, Sarah Leblanc, Arthur Belle, Einas Abouali, Romain Coriat, Stanislas Chaussade, Philippe Soyer

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Article in European radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 19% 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

3 citing papers in PubMed, 9 citations in OpenAlex.

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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

9 authors at 2 institutions in 1 country.

Maximilien BarretDepartment of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg St Jacques, 75014, Paris, France. maximilien.barret@aphp.fr.ORCID http://orcid.org/0000-0002-0566-7870
Anthony DohanUniversity of Paris, Descartes Paris 5, 75006, Paris, France.
Ammar OudjitDepartment of Abdominal and Interventional Imaging, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 75014, Paris, France.
Sarah LeblancDepartment of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg St Jacques, 75014, Paris, France.
Arthur BelleDepartment of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg St Jacques, 75014, Paris, France.
Einas AboualiDepartment of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg St Jacques, 75014, Paris, France.
Romain CoriatDepartment of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg St Jacques, 75014, Paris, France.
Stanislas ChaussadeDepartment of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg St Jacques, 75014, Paris, France.
Philippe SoyerUniversity of Paris, Descartes Paris 5, 75006, Paris, France.
Délégation Paris 5 · FRHôpital Cochin · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEsophageal peroral endoscopic myotomy (POEM) is the treatment of reference of major obstructive esophageal motility disorders but the detection of early complications remains challenging. Our aim was to report the radiological findings on meglumine diatrizoate esophagograms after esophageal POEM and identify variables associated with patient outcomes.

methodsThe imaging and clinical files of 106 patients who underwent POEM for achalasia or other major obstructive esophageal motility disorders were retrospectively analyzed. Post POEM esophagograms were reviewed for the presence of pneumoperitoneum, pleural effusion, extraesophageal contrast leakage, and dislocated clips. Associations between length of hospital stay and radiological findings were searched for using a Cox multivariate analysis.

resultsA total of 106 patients (M/F = 56/50; mean age = 50 ± 2 [SD] years) underwent 106 POEM procedures with a meglumine diatrizoate esophagogram on postoperative day 1. Overall median hospital stay was 3 days (range 1-20 days). Pneumoperitoneum, pleural effusion, extraesophageal contrast leakage, and dislocated clips were observed in 90/106 (84.9%), 12/106 (11.3%), 4/106 (3.8%), and 0/106 (0%) patients, respectively. At multivariate analysis, pleural effusion (p = 0.005; adjusted hazard ratio [aHR] = 0.35 [95% CI 0.17-0.73]) and extraesophageal contrast leakage (p = 0.039; aHR = 0.27 [95% CI 0.08-0.94]) were associated with a prolonged hospital stay. Pneumoperitoneum was not associated with unfavorable outcome (p = 0.99).

conclusionsPneumoperitoneum is a common finding after POEM and is not indicative of unfavorable patient outcome. Conversely, post POEM pleural effusion and extraesophageal contrast leakage are associated with a longer hospital stay. KEY POINTS: • Water-soluble esophagogram is a valid diagnostic modality to diagnose early complications after esophageal endoscopic myotomy for esophageal motility disorders. • At multivariate analysis, pleural effusion and extraesophageal contrast leakage are associated with a prolonged hospital stay after peroral endoscopic myotomy. • Pneumoperitoneum is not associated with unfavorable outcome after peroral endoscopic myotomy.

Indexed as

Contrast MediaDiatrizoate MeglumineLength of StayAdultAgedEsophageal AchalasiaEsophageal Motility DisordersEsophagusFemaleHumansMaleMiddle AgedMyotomyNatural Orifice Endoscopic SurgeryPneumoperitoneumPostoperative ComplicationsContrast MediaDiatrizoate MeglumineAchalasiaEsophageal motility disordersEsophageal perforationMeglumine diatrizoate esophagogramPeroral endoscopic myotomy (POEM)

Identifiers

PMID32170414
OpenAlexW3011096151

What OpenQuestion holds

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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.