A comparative study on effects of three measuring methods for gastroesophageal reflux of post-POEM achalasia patients

Abstract

Background: Gastroesophageal reflux is a major complication of post-POEM (peroral endoscopic myotomy, POEM) for esophageal achlasia. Objective: To discuss the effects of three measuring methods for Gastroesophageal Reflux of Post-POEM Achalasia Patients and find out the best method for diagnosing post-POEM gastroesophageal reflux of esophageal achalasia patients by conducting clinical follow-up studies. Methods: Follow-up visits were conducted on the patients with esophageal achalasia who had received POEM treatment in our hospital from 2013 to 2016. Between 2 to 4 weeks post operation, Eckardt score was adopted to evaluate the operation efficacy, the GerdQ score, electronic gastroscopy and 24h esophagus impedance-pH monitoring to investigate the gastroesophageal reflux and the comparison of detection rate among the three different methods on post-POEM gastroesophageal reflux. Results: There were 76 patients with Eckardt scores were 3 or lower than 3 post POEM (76/78, 97.44%), 2 patients with Eckardt scores were 4 or higher than 4 (2/78, 2.56%), the cure rate of the treatment was as high as 97.44%; the Eckardt score post operation decreased more significantly than before operation, P<0.0.5. Conclusion: for post-POEM Achalasia patients, 24h esophagus impedance-pH monitoring is the best way to diagnose post-POEM gastroesophageal reflux.