Evidence map›Paper›PMID 38992281›Full record

ArticleSurgical endoscopy2024

Efficacy and outcomes of per oral plication of the (neo)esophagus (POPE) for impaired emptying in achalasia and post-esophagectomy patients.

Trevor D Crafts, Henry Seidel, Herbert M Hedberg, Kristine Kuchta, JoAnn Carbray, Derrius J Anderson, Stephanie Joseph, Jean-Christophe Rwigema, Shun Ishii, Michael B Ujiki

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Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

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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

10 authors.

Trevor D CraftsDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA. craftstrevor@gmail.com.ORCID 0000-0002-5860-8014
Henry SeidelDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.
Herbert M HedbergDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.
Kristine KuchtaDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.
JoAnn CarbrayDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.
Derrius J AndersonDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.
Stephanie JosephDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.
Jean-Christophe RwigemaDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.
Shun IshiiDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.
Michael B UjikiDepartment of Surgery, Endeavor Health, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPer-oral plication of the (neo)esophagus (POPE) is an endoscopic procedure used to improve emptying of the defunctionalized esophagus or gastric conduit, with the hope of improving symptoms and quality of life. As this procedure has only been performed in the United States for the past 4 years, safety and efficacy have not been well established.

methodsThis is a retrospective case series for patients who underwent POPE from a single institution between 2019 and 2023. Data collected included demographics, preoperative diagnoses and treatments, imaging, endoscopic data, operative intervention, 90-day complications, and response to treatment. Quality of life and patient satisfaction data were collected by phone survey.

resultsSeventeen cases were identified, encompassing 13 primary procedures and 4 repeat POPEs (re-POPE). Eight patients had end-stage achalasia and 5 had impaired gastric emptying after esophagectomy with gastric conduits. Median age was 65 years and median ASA was 3, with 38.5% female patients. POPE was performed with 2-6 plication sutures in an average of 75 min. The majority of patients discharged home the same day. For the 17 procedures, there were 4 complications. Two patients required antibiotics for pneumonia, while 4 required procedural intervention. There were no deaths. Preoperative symptoms improved or resolved at initial follow up in 82.3% of patients. Four patients experienced symptom recurrence and required re-POPE, 1 with achalasia and 3 with gastric conduits. Although all achalasia patients had an "end-stage esophagus," none have required esophagectomy since the introduction of POPE.

conclusionsPOPE is an endoscopic procedure that is efficacious in relieving emptying difficulties for the end-stage esophagus and gastric conduit. It may obviate the need for esophagectomy or conduit replacement. Also, it can be repeated in select patients. While the risk profile of complications is favorable compared to alternative operations, patients with gastric conduits are at higher risk.

Indexed as

Esophageal AchalasiaEsophagectomyPostoperative ComplicationsAdultAgedEsophagusFemaleHumansMaleMiddle AgedPatient SatisfactionQuality of LifeRetrospective StudiesTreatment OutcomeAchalasiaEndoscopic suturingEnd-stage esophagusEsophagectomyGastric conduitPlication

Identifiers

PMID38992281

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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.