Peroral endoscopic myotomy for idiopathic achalasia: randomized comparison of water-jet assisted versus conventional dissection technique

Cai, Mingjun; Zhou, Ping‐Hong; Yao, Ling; Xu, Mei‐Dong; Zhong, Yun‐Shi; Li, Quan‐Lin; Chen, Weifeng; Hu, Jianwei; Zhao, Chunhe; Zhu, Boqun

doi:10.1007/s00464-013-3300-1

Cited by 77 publications

(41 citation statements)

References 14 publications

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“…9,23 The group at Zhongshan Hospital, Shanghai, compared the T-type hybrid knife and triangular tip knife in a head-to-head, prospective, randomized study of 100 patients, which revealed shorter procedure time, lower bleeding rate, and less frequent use of coagulation forceps to control bleeding with the T-type hybrid knife. 44 No other comparative data exist regarding tunnel dissection techniques.…”

Section: Per-oral Endoscopic Myotomy For Achalasia: the Historical Anmentioning

confidence: 99%

“…22 Another technique uses electrosurgical dissection with the T-type hybrid knife (ERBE, Tübingen, Germany), an ESD knife that allows injection of saline solution through the tip of the knife, obviating the need for repeated accessory exchanges between needle injector and knife that are needed with the triangular-tip knife. 44 An alternative technique, possibly more accessible to those with modest ESD experience, uses a through-the-scope dilation balloon such as a short-nosed biliary extraction balloon or a longer esophageal dilation balloon (CRE; Boston Scientific, Natick, Mass) to dissect the submucosal tunnel without electrosurgery. 9,23 The group at Zhongshan Hospital, Shanghai, compared the T-type hybrid knife and triangular tip knife in a head-to-head, prospective, randomized study of 100 patients, which revealed shorter procedure time, lower bleeding rate, and less frequent use of coagulation forceps to control bleeding with the T-type hybrid knife.…”

Section: Per-oral Endoscopic Myotomy For Achalasia: the Historical Anmentioning

confidence: 99%

See 1 more Smart Citation

Per-oral endoscopic myotomy white paper summary

Stavropoulos

Desilets

Fuchs

et al. 2014

Gastrointestinal Endoscopy

159

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Section: Per-oral Endoscopic Myotomy For Achalasia: the Historical Anmentioning

confidence: 99%

Section: Per-oral Endoscopic Myotomy For Achalasia: the Historical Anmentioning

confidence: 99%

Per-oral endoscopic myotomy white paper summary

Stavropoulos

Desilets

Fuchs

et al. 2014

Gastrointestinal Endoscopy

159

View full text Add to dashboard Cite

“…43 Partial duplication Cai 44 Partial duplication Ren 45 Partial duplication Minami 35 Partial duplication Bhayani 46 Partial duplication Swanstrom 47 Partial duplication Swanstrom 48 Partial duplication Sharata 49 Partial duplication Onimaru 50 Population non representative…”

Section: Conflict Of Interestmentioning

confidence: 99%

Systematic review and meta‐analysis: Efficacy and safety of POEM for achalasia

Barbieri¹,

Hassan²,

Rosati³

et al. 2015

UEG Journal

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Background: Peroral endoscopic esophageal myotomy (POEM) represents a less invasive alternative, as compared with conventional laparoscopic Heller myotomy for treating achalasia patients. In the last years, a number of prospective and retrospective experiences with POEM use for achalasia have been published. Methods: Relevant publications in which patients affected by achalasia underwent POEM treatment were identified by PubMed databases for the period 2010 -2013. From each study, we extracted the number and type of major complications (defined as those requiring any additional medical or surgical intervention). Data were pooled, using random-effects models. Heterogeneity among studies was assessed by using Cochran's Q and the I 2 statistic. Results: We found 16 studies that provided data on 551 patients. The median surveillance period was 6 months (range: 3-12). The median of mean POEM duration was 156 minutes (range: 42-112). Median myotomy length was 10 cm (range: 6-14). Technical and clinical success were reported in 97% (95% CI: 94-98%) and 93% (407/428; 95% CI: 90-95%). No heterogeneity (I 2 ¼ 0%) or publication bias was present in both estimates. When limiting the analysis only to adverse events that require medical or surgical interventions, major adverse events occurred in 14% (95% CI: 11-17%); however, only one patient needed post-POEM surgery (0.2%; 95% CI: 0-0.5%). Conclusions: POEM appeared to be a highly feasible and effective endoscopic treatment for achalasia. Despite POEM being apparently associated with relatively high morbidity, most patients are successfully managed conservatively, so that POEM appears as a very safe procedure; however, POEM should only be performed in centers able to treat POEM complications, such as pneumothorax or pneumoperitoneum.

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“…Most centers prefer to use a triangular tip (TT) knife, while only a few centers apply the Hybrid knife (HK) [11]. As for the two different endoscopic equipments, limited reports assessed and compared their clinical outcomes in POEM procedure [12]. Therefore, in this casecontrol study, we aimed to evaluate the procedure time, efficacy and safety of the HK in comparison to the TT technique during POEM procedure.…”

Section: Introductionmentioning

confidence: 98%