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Incidence and risk factors of reflux esophagitis after peroral endoscopic myotomy.
Wessels, Elise M; Masclee, Gwen M C; Bastiaansen, Barbara A J; Fockens, Paul; Bredenoord, Albert J.
Afiliación
  • Wessels EM; Department of Gastroenterology & Hepatology, Amsterdam Gastroenterology and Metabolism, University Medical Centers Amsterdam, Amsterdam, the Netherlands.
  • Masclee GMC; Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands.
  • Bastiaansen BAJ; Department of Gastroenterology & Hepatology, Amsterdam Gastroenterology and Metabolism, University Medical Centers Amsterdam, Amsterdam, the Netherlands.
  • Fockens P; Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands.
  • Bredenoord AJ; Department of Gastroenterology & Hepatology, Amsterdam Gastroenterology and Metabolism, University Medical Centers Amsterdam, Amsterdam, the Netherlands.
Neurogastroenterol Motil ; 36(6): e14794, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38587128
ABSTRACT

BACKGROUND:

Peroral endoscopic myotomy (POEM) is an effective and safe treatment for achalasia, but often leads to posttreatment gastroesophageal reflux disease. The aim of this study was to examine the incidence and severity of reflux esophagitis after POEM and to identify associated predictive factors.

METHODS:

Patients who underwent POEM between August 2011 and December 2022 were included. Multivariate logistic regression was used to assess predictive factors for reflux esophagitis after POEM. KEY

RESULTS:

In total, 252 patients were included; of which, 46% were female and age ranged between 18 and 87 years. Reflux esophagitis within 1 year after POEM was observed in 131 patients (52%), which was severe in 29 patients (LA grade C/D, 12%). Length of full-thickness myotomy (cm; OR 1.11, 95% CI 1.02-1.21), Eckardt scores before POEM (OR 0.84, 95% CI 0.74-0.96), previous pneumatic dilation (OR 0.51, 95% CI 0.29-0.91), and previous laparoscopic Heller myotomy (LHM; OR 0.44, 95% CI 0.23-0.86) were associated with reflux esophagitis after POEM. Alcohol use (none vs > 7 units per week; OR 3.51, 95% CI 1.35-9.11) and overweight (BMI ≥25 kg/m2; OR 2.67, 95% CI 1.17-6.09) were positive predictive factors and previous LHM (OR 0.13, 95% CI 0.02-0.95) was a negative predictive factor for severe reflux esophagitis after POEM (LA grade C/D).

CONCLUSION:

About half of the patients develop reflux esophagitis after POEM and 12% is graded as severe. Recognizing predictive factors of reflux esophagitis after POEM treatment leads to better patient selection before POEM and provides an opportunity to take preventive measures or start preemptive treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Acalasia del Esófago / Esofagitis Péptica Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Neurogastroenterol Motil Asunto de la revista: GASTROENTEROLOGIA / NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Acalasia del Esófago / Esofagitis Péptica Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Neurogastroenterol Motil Asunto de la revista: GASTROENTEROLOGIA / NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido