Short-term safety and efficacy of peroral endoscopic myotomy for the treatment of achalasia in children

Liu, Zuqiang; Wang, Yun; Fang, Ying; Huang, Ying; Yang, Hongbin; Ren, Xiaoxia; Xu, Mei‐Dong; Chen, Shiyao; Chen, Weifeng; Zhong, Yun‐Shi; Zhang, Yiqun; Qin, Wen‐Zheng; Hu, Jianwei; Cai, Ming‐Yan; Yao, Ling; Li, Quan‐Lin; Zhou, Ping‐Hong

doi:10.1007/s00535-019-01607-4

Cited by 22 publications

(29 citation statements)

References 28 publications

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“…Overall, clinical success was recorded in 95% (per protocol) and 86% (intention to treat) of children at ≥4 years follow-up. In previously published studies with relatively long follow-up periods, the clinical success rate of POEM in pediatric achalasia ranged from 95 to 100% at followup ranging from 26 to 40 months (3,8,14,15) (Table 4). Our results suggest that in pediatric achalasia, the response to POEM is sustained for at least 4 years.…”

Section: Discussionmentioning

confidence: 99%

“…In pediatric cases with achalasia, Heller's myotomy and pneumatic dilatation are the preferred treatment modalities (13). Emerging data suggest that POEM is an effective alternative to pneumatic dilatation and Heller's myotomy in pediatric achalasia as well (6)(7)(8). However, there is limited data to suggest the long-term efficacy of POEM in children and adolescents.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have established the safety and efficacy of POEM in adults with achalasia. Emerging data suggest that POEM may be an effective treatment in children and adolescents as well (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). However, there are limited data on the long-term outcomes of POEM in the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

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POEM Is a Durable Treatment in Children and Adolescents With Achalasia Cardia

et al. 2022

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Background and AimPer-oral endoscopic myotomy (POEM) is emerging as an effective treatment for pediatric achalasia. There are limited data on the long-term efficacy of POEM in children and adolescents with achalasia. In this study, we aim to evaluate the outcomes of POEM at ≥4 years follow-up.MethodThe data of consecutive children who underwent POEM (September 2013–July 2021) and completed at least 4 years follow-up were analyzed retrospectively. The primary outcome was clinical success (Eckardt ≤ 3) at ≥4 years follow-up. The secondary outcomes included the prevalence of gastroesophageal reflux disease (GERD) and predictors of recurrent symptoms (Eckardt ≥2) after POEM.ResultsA total of 69 children underwent POEM for achalasia during the study period. Of these, 41 (59.4%) children completed ≥4 years [mean 68.5 months (range 48–94)] follow-up, and 38 were included in the final analysis. The subtypes of achalasia included type I (28.9%), type II (60.5%), and type III (2.6%). There was a history of prior treatment in 11 children (28.9%). Clinical success was recorded in 36 (94.7%) patients who successfully underwent POEM. Recurrent symptoms (Eckardt ≥ 2) were noticed in 12 (31.6%) children at ≥4 years. On multivariate analysis, there were no identifiable factors which predicted recurrent symptoms after POEM. Symptomatic GERD and erosive esophagitis were detected in 13.8% (4/29) and 57.1% (8/14) of the children, respectively.ConclusionPOEM is a durable treatment modality for achalasia in the pediatric population irrespective of the sub-type of achalasia and history of prior treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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POEM Is a Durable Treatment in Children and Adolescents With Achalasia Cardia

et al. 2022

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“…Achalasia is a rare progressive motility disorder, characterized by esophageal aperistalsis and impaired LES relaxation, leading to increased dysphagia of solids and liquids and regurgitation of indigested contents (77)(78)(79)(80)(81)(82). Its presentation is particular in adult life, and diagnosis in childhood is quite rare.…”

Section: Peroral Endoscopic Myotomy (Poem)mentioning

confidence: 99%

Therapeutic Upper Gastrointestinal Endoscopy in Pediatric Gastroenterology

2022

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“…Few small studies have concluded that POEM is a safe procedure in pediatric poulation. [56][57][58][59] A recent multicentre study including 117 children reported the outcomes of POEM in children with achalasia. AE in this study included bleeding (1%), aspiration pneumonia (2%), mucosotomies (4%), subcutaneous emphysema (2%), esopleural fistula (1%; required endoscopic fistulotomy with surgical drainage), and GER (15%).…”

Section: Safety Of Submucosal Endoscopy In Special Populationmentioning

confidence: 99%

Adverse events associated with third space endoscopy: Diagnosis and management

Chavan

Nabi

Reddy

2020

Int J Gastrointest Interv

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Third space endoscopy (TSE) is a 'magnum opus' in the field of therapeutic gastrointestinal (GI) endoscopy that has led to a paradigm shift in the management of various GI disorders. TSE or submucosal endoscopy is based on the concept of mucosal flap safety valve technique. Since, the basic principle is more or less similar for all the TSE procedures, the nature of major adverse events (AE) also shares some similarity across the spectrum of TSE procedures. These AE include insufflation related AE, bleeding, perforation, and infection. Insufflation related events are among the most commonly encountered AEs. However, majority of the insufflation related AE do not require a specific intervention and not regarded as AE in true sense. Identification of risk factors and adaptation of preventative strategies may help in reducing the incidence of AE. At the same time, early recognition and expeditious management is paramount to reduce morbidities associated with these AE. Due to heterogeneity in the reporting of AE, it is difficult to estimate the actual incidence of AE and compare the results between different studies. Therefore, universal adaptation of a standard reporting system is required to quantify the true incidence of AE for each procedure.

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Short-term safety and efficacy of peroral endoscopic myotomy for the treatment of achalasia in children

Cited by 22 publications

References 28 publications

POEM Is a Durable Treatment in Children and Adolescents With Achalasia Cardia

POEM Is a Durable Treatment in Children and Adolescents With Achalasia Cardia

Therapeutic Upper Gastrointestinal Endoscopy in Pediatric Gastroenterology

Adverse events associated with third space endoscopy: Diagnosis and management

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