Evidence map›Paper›PMID 32845401›Full record

ArticleSurgical endoscopy2021

Endoscopic ultrasound: a powerful tool to modify treatment algorithms in opioid-induced achalasia.

Arielle M Lee, Josefin Holmgren, Ryan C Broderick, Joslin N Cheverie, Bryan J Sandler, Garth R Jacobsen, Wilson T Kwong, David C Kunkel, Santiago Horgan

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 49% 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

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

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.

Arielle M LeeDepartment of Surgery, Division of Minimally Invasive Surgery, UC San Diego School of Medicine, University of California San Diego, San Diego, CA, USA. aml133@health.ucsd.edu.ORCID http://orcid.org/0000-0003-4475-7673
Josefin HolmgrenDepartment of Surgery, Division of Minimally Invasive Surgery, UC San Diego School of Medicine, University of California San Diego, San Diego, CA, USA.
Ryan C BroderickDepartment of Surgery, Division of Minimally Invasive Surgery, UC San Diego School of Medicine, University of California San Diego, San Diego, CA, USA.
Joslin N CheverieDepartment of Surgery, Division of Minimally Invasive Surgery, UC San Diego School of Medicine, University of California San Diego, San Diego, CA, USA.
Bryan J SandlerDepartment of Surgery, Division of Minimally Invasive Surgery, UC San Diego School of Medicine, University of California San Diego, San Diego, CA, USA.
Garth R JacobsenDepartment of Surgery, Division of Minimally Invasive Surgery, UC San Diego School of Medicine, University of California San Diego, San Diego, CA, USA.
Wilson T KwongDivision of Gastroenterology, Department of Medicine, University of California San Diego, San Diego, CA, USA.
David C KunkelDivision of Gastroenterology, Department of Medicine, University of California San Diego, San Diego, CA, USA.
Santiago HorganDepartment of Surgery, Division of Minimally Invasive Surgery, UC San Diego School of Medicine, University of California San Diego, San Diego, CA, USA.
University of California San Diego · USUC San Diego Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOpioid use in the U.S. has increased dramatically over the last 15 years, recently being declared a public health emergency. Opioid use is associated with esophageal dysmotility lending to a confusing clinical picture compared to true achalasia. Patients exhibit symptoms and elicit diagnostic results consistent with esophageal motility disorders, in particular type III achalasia. Modified therapeutic strategies and outcomes become challenging. Differentiating true achalasia from opioid-induced achalasia is critical. Conventional surgical interventions, i.e., myotomy, are ineffective in the absence of true achalasia. We assess the utility of esophageal muscle layer mapping with endoscopic ultrasound (EUS) in distinguishing primary from opioid-induced achalasia.

methodsFrom 2016 to 2019, patients with abnormal manometry and suspected achalasia underwent esophagogastroduodenoscopy and EUS mapping of esophageal round muscle layer thickness. Maximum round layer thickness and length of round muscle layer thickness > 1.8 mm were collected and compared between opioid users and non-opioid users using Wilcoxon Rank sum test.

results45 patients were included: 12 opioid users, 33 non-opioid users. Mean age 56.8 years (range 24-93), 53.3% male patients. Mean BMI in the opioid-induced achalasia group was 30.2 kg/m

conclusionEndoscopic ultrasound is an essential tool that has improved our treatment algorithm for suspected achalasia in patients with chronic opioid usage. Incorporation of EUS findings into treatment approach may prevent unnecessary surgery in opioid users.

Indexed as

Esophageal AchalasiaEsophageal Motility DisordersMyotomyNatural Orifice Endoscopic SurgeryAdultAgedAged, 80 and overAlgorithmsAnalgesics, OpioidEsophageal Sphincter, LowerFemaleHumansMaleManometryMiddle AgedTreatment OutcomeAnalgesics, OpioidAchalasiaEndoscopic ultrasoundEsophageal dysmotilityForegutMotility

Identifiers

PMID32845401
OpenAlexW3081396142

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.