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논문 기본 정보

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학술저널
저자정보
Zuzana Vackova (Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine Prague Czec) Jan Mares (Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine Prague Czec) Jana Krajciova (Institute of Physiology 1st Faculty of Medicine Charles University Prague Czech Republic) Zuzana Rabekova (Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine Prague Czec) Lucie Zdrhova (Department of Internal Medicine University Hospital Plzen Czech Republic) Pavla Loudova (Department of Gastroenterology Hospital Kolin Czech Republic) Julius Spicak (Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine Prague Czec) Petr Stirand (Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine Prague Czec) Tomas Hucl (Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine Prague Czec) Jan Martinek (Ostrava University Faculty of Medicine Ostrava Czech Republic)
저널정보
대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.27 No.2
발행연도
2021.1
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205 - 214 (10page)

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Background/AimsSeveral studies have reported partial recovery of peristalsis in patients with achalasia after myotomy. The aim of our study is to analyze esophageal motility patterns after peroral endoscopic myotomy (POEM) and to assess the potential predictors and clinical impact of peristaltic recovery. MethodsWe performed a retrospective analysis of prospectively collected data of consecutive patients with achalasia undergoing POEM at a tertiary center. High-resolution manometry (HRM) studies prior to and after POEM were reviewed and the Chicago classification was applied. ResultsA total of 237 patients were analyzed. The initial HRM diagnoses were achalasia type I, 42 (17.7%); type II, 173 (73.0%); and type III, 22 (9.3%). Before POEM, peristaltic fragments were present in 23 (9.7%) patients. After POEM the Chicago classification diagnoses were: 112 absent contractility, 42 type I achalasia, 15 type II, 11 type III, 26 ineffective esophageal motility, 18 esophagogastric junction outflow obstruction, 10 fragmented peristalsis, and 3 distal esophageal spasm. Altogether 68 patients (28.7%) had signs of contractile activity, but the contractions newly appeared in 47 patients (47/214, 22.0%). Type II achalasia showed a trend for appearance of contractions (P = 0.097). Logistic regression analysis did not identify any predictors of peristaltic recovery. The post-POEM Eckardt score did not differ between patients with and without contractions nor did the parameters of timed barium esophagogram. ConclusionsMore than 20% of achalasia patients have signs of partial recovery of esophageal peristalsis after POEM. It occurs predominantly in type II achalasia but the clinical relevance seems to be negligible.
#Esophageal achalasia #Manometry #Myotomy #Peristalsis

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참고문헌 (28)

참고문헌 신청
Inoue H / 2010 / Peroral endoscopic myotomy(POEM)for esophageal achalasia / Endoscopy 42:265~271 google schola Werner YB / 2019 / Endoscopic or surgical myotomy in patients with idiopathic achalasia / New Engl J Med 381:2219~2229 google schola von Renteln D / 2012 / Peroral endoscopic myotomy for the treatment of achalasia : a prospective single center study / Am J Gastroenterol 107:411~417 google schola Teitelbaum EN / 2014 / Symptomatic and physiologic outcomes one year after peroral esophageal myotomy(POEM)for treatment of achalasia / Surg Endosc 28:3359~3365 google schola Moonen A / 2016 / Long-term results of the European achalasia trial : a multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy / Gut 65:732~739 google schola

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