Evidence map›Paper›PMID 40715655›Full record

ArticleSurgical endoscopy2025

Endoscopic management of esophagomediastinal fistula following peroral endoscopic myotomy.

Shao-Bin Luo, Li Wang, Zu-Qiang Liu, Yi-Qun Zhang, Wei-Feng Chen, Li-Li Ma, Jian-Wei Hu, Ming-Yan Cai, Quan-Lin Li, Ping-Hong Zhou

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

10 authors.

Shao-Bin Luo *Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Li Wang *Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Zu-Qiang LiuEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Yi-Qun ZhangEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Wei-Feng ChenEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Li-Li MaEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Jian-Wei HuEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Ming-Yan CaiEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Quan-Lin LiEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. li.quanlin@zs-hospital.sh.cn.
Ping-Hong ZhouEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. zhou.pinghong@zs-hospital.sh.cn.ORCID http://orcid.org/0000-0002-5434-0540

Funding

Shanghai Academic/Technology Research Leader 22XD1422400Shuguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission 22SG06the National Natural Science Foundation of China 82000507the National Natural Science Foundation of China 82170555the National Natural Science Foundation of China 82370546Youth Foundation of Shanghai Geriatric Medical Center YQ2024-010
6 · The paper itself

Abstract

objectivesEsophagomediastinal fistula (EMF) is a rare but important major adverse event (mAE) after peroral endoscopic myotomy (POEM), which is scarcely reported. This study aimed to offer a comprehensive analysis of the evaluation and management of EMF following POEM.

methodFrom June 2015 to December 2023, we retrospectively reviewed patients with achalasia receiving POEM. Patients diagnosed with postoperative EMF were included. Clinical characteristics, outcomes, and follow-up of EMF were analyzed.

resultsThere were 10 cases of EMF in patients (6 men; median age 37 years). The location of the EMF was the tunnel's entrance (3 cases) and the middle of the tunnel (7 cases). The most common accompanying symptoms were febrile episodes (9 cases), retrosternal pain (5 cases), and chest tightness (3 cases). The findings of the initial postoperative CT scan included pleural effusion (6 cases), pneumothorax (4 cases), mediastinal emphysema or effusion (4 cases), and subcutaneous emphysema (1 case). The median duration from POEM procedure to the diagnosis of the fistula was 8 days (range 4-18). The fistula was successfully controlled by nasogastric tube combined with nasojejunal tube insertion (8 cases), gastric drainage tube inserted into the tunnel (5 cases), debridement within the tunnel (4 cases), tunnel mucosal incision (1 case). No patient required surgical intervention. All patients received antibiotics and nutritional support. Eight patients required thoracic drainage. The median post-fistula and total hospital stays were 25 days (range 13-54) and 22 days (range 11-51), respectively.

conclusionsThis comprehensive management approach demonstrated its effectiveness, and all EMFs were successfully treated without requiring subsequent surgical interventions.

Indexed as

Esophageal AchalasiaEsophageal FistulaEsophagoscopyMediastinal DiseasesMyotomyNatural Orifice Endoscopic SurgeryPostoperative ComplicationsAdultFemaleHumansMaleMiddle AgedRetrospective StudiesYoung AdultAchalasiaEsophagomediastinal fistulaPeroral endoscopic myotomy

Identifiers

PMID40715655

What OpenQuestion holds

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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.