Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video)
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Background/Aims: Peroral endoscopic myotomy (POEM) has recently come to the forefront in the management of achalasia. Weaimed to analyze the efficacy and safety of the use of electrocautery enhanced scissors (EES) for POEM. Methods: This retrospective cohort study prospectively collected the data of all adult patients (aged ≥18 years) with normal foregutanatomy who underwent POEM using EES. The patients’ baseline characteristics and procedure details (time, tunnel length,myotomy length, depth, and location) were recorded. The primary outcome was clinical success (3-month post-procedure Eckardtscore of ≤3). The secondary outcomes were technical success and adverse events. A paired Student’s t-test was performed. Results: Fifteen patients were included in this study. The technical success rate of myotomy using EES was 100%. Fellows participatedin the myotomy in all cases. The clinical success rate was 93.3% (14/15). The mean pre-Eckardt score was 5.4±2.5, while the meanpost-Eckardt score was 1.3±1.3, which indicated a significant improvement (p≤0.0001). The most common treatment-related adverseevents were post-procedure pain (4, 26.7%) and symptomatic reflux disease (4, 26.7%). Conclusions: In the largest series to date on the use of EES in POEM, we demonstrated that this technique has both technical andclinical efficacy as well as an excellent safety profile.
Abstract
Background/Aims: Peroral endoscopic myotomy (POEM) has recently come to the forefront in the management of achalasia. Weaimed to analyze the efficacy and safety of the use of electrocautery enhanced scissors (EES) for POEM. Methods: This retrospective cohort study prospectively collected the data of all adult patients (aged ≥18 years) with normal foregutanatomy who underwent POEM using EES. The patients’ baseline characteristics and procedure details (time, tunnel length,myotomy length, depth, and location) were recorded. The primary outcome was clinical success (3-month post-procedure Eckardtscore of ≤3). The secondary outcomes were technical success and adverse events. A paired Student’s t-test was performed. Results: Fifteen patients were included in this study. The technical success rate of myotomy using EES was 100%. Fellows participatedin the myotomy in all cases. The clinical success rate was 93.3% (14/15). The mean pre-Eckardt score was 5.4±2.5, while the meanpost-Eckardt score was 1.3±1.3, which indicated a significant improvement (p≤0.0001). The most common treatment-related adverseevents were post-procedure pain (4, 26.7%) and symptomatic reflux disease (4, 26.7%). Conclusions: In the largest series to date on the use of EES in POEM, we demonstrated that this technique has both technical andclinical efficacy as well as an excellent safety profile.
참고문헌 (36)
- Tang X, "Comparison of conventional versus hybrid knife peroral endoscopic myotomy methods for esophageal achalasia : a case-control study", Scand J Gastroenterol, 51, pp.494~500 (2016)
- Stavropoulos SN, "The international per oral endoscopic myotomy survey(IPOEMS) : a snapshot of the global POEM experience", Surg Endosc, 27, pp.3322~3338 (2013)
- Inoue H, "Peroral endoscopic myotomy(POEM)for esophageal achalasia", Endoscopy, 42, pp.265~271 (2010)
- "SB knives" (2020)[URL]
- Cotton PB, "A lexicon for endoscopic adverse events : report of an ASGE workshop", Gastrointest Endosc, 71, pp.446~454 (2010)
- Schlottmann F, "Laparoscopic Heller myotomy versus peroral endoscopic myotomy(POEM)for achalasia : a systematic review and meta-analysis", Ann Surg, 267, pp.451~460 (2018)
- Von Renteln D, "Peroral endoscopic myotomy for the treatment of achalasia : an international prospective multicenter study", Gastroenterology, 145, pp.309~311 (2013)
- Li QL, "Peroral endoscopic myotomy for the treatment of achalasia : a clinical comparative study of endoscopic full-thickness and circular muscle myotomy", J Am Coll Surg, 217, pp.442~451 (2013)
- Minami H, "Peroral endoscopic myotomy for esophageal achalasia : clinical impact of 28 cases", Dig Endosc, 26, pp.43~51 (2014)
- Cai MY, "Peroral endoscopic myotomy for idiopathic achalasia : randomized comparison of water-jet assisted versus conventional dissection technique", Surg Endosc, 28, pp.1158~1165 (2014)
- Ling TS, "Effectiveness of peroral endoscopic myotomy in the treatment of achalasia : a pilot trial in Chinese Han population with a minimum of one-year follow-up", J Dig Dis, 15, pp.352~358 (2014)
- Patel KS, "The light at the end of the tunnel : a single-operator learning curve analysis for per oral endoscopic myotomy", Gastrointest Endosc, 81, pp.1181~1187 (2015)
- Chen X, "Two-year follow-up for 45 patients with achalasia who underwent peroral endoscopic myotomy", Eur J Cardiothorac Surg, 47, pp.890~896 (2015)
- Kumagai K, "Per-oral endoscopic myotomy for achalasia. Are results comparable to laparoscopic Heller myotomy?", Scand J Gastroenterol, 50, pp.505~512 (2015)
- Liu XJ, "The outcomes and quality of life of patients with achalasia after peroral endoscopic myotomy in the shortterm", Ann Thorac Cardiovasc Surg, 21, pp.507~512 (2015)
- Sharata AM, "Peroral endoscopic myotomy(POEM)for esophageal primary motility disorders : analysis of 100 consecutive patients", J Gastrointest Surg, 19, pp.161~170 (2015)
- Inoue H, "Per-oral endoscopic myotomy : a series of 500 patients", J Am Coll Surg, 221, pp.256~264 (2015)
- Hu Y, "Esophageal motility after peroral endoscopic myotomy for achalasia", J Gastroenterol, 51, pp.458~464 (2016)
- Werner YB, "Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years", Gut, 65, pp.899~906 (2016)
- Schneider AM, "A matched comparison of per oral endoscopic myotomy to laparoscopic Heller myotomy in the treatment of achalasia", J Gastrointest Surg, 20, pp.1789~1796 (2016)
- Lv L, "Peroral endoscopic full-thickness myotomy for the treatment of sigmoid-type achalasia : outcomes with a minimum follow-up of 12 months", Eur J Gastroenterol Hepatol, 28, pp.30~36 (2016)
- Worrell SG, "Peroral endoscopic myotomy for achalasia in a thoracic surgical practice", Ann Thorac Surg, 101, pp.218~224 (2016)
- Hungness ES, "Per-oral endoscopic myotomy(POEM)after the learning curve : durable long-term results with a low complication rate", Ann Surg, 264, pp.508~517 (2016)
- Familiari P, "Peroral endoscopic myotomy for esophageal achalasia : outcomes of the first 100 patients with shortterm follow-up", Ann Surg, 263, pp.82~87 (2016)
- Stavropoulos SN, "Per oral endoscopic myotomy, equipment and technique : a step-by-step explanation", Video Journal and Encyclopedia of GI Endoscopy, 1, pp.96~100 (2013)
- 고봉민, "History and Development of Accessories for Endoscopic Submucosal Dissection", Clinical Endoscopy, 50(3), pp.219~223 (2017), 대한소화기내시경학회
- Honma K, "Endoscopic submucosal dissection for colorectal neoplasia", Dig Endosc, 22, pp.307~311 (2010)
- Yamashina T, "Scissor-type knife significantly improves self-completion rate of colorectal endoscopic submucosal dissection : single-center prospective randomized trial", Dig Endosc, 29, pp.322~329 (2017)
- Ge PS, "Endoscopic submucosal dissection of a large cecal polyp using a scissor-type knife : implications for training in ESD", VideoGIE, 3, pp.313~315 (2018)
- Nabi Z, "Per-oral endoscopic myotomy for achalasia cardia : outcomes in over 400 consecutive patients", Endosc Int Open, 5, pp.E331~E339 (2017)
- Hirano T, "Two cases of pseudo-achalasia with lung cancer : case report and short literature review", Respir Investig, 54, pp.494~499 (2016)
- Barbieri LA, "Systematic review and meta-analysis : efficacy and safety of POEM for achalasia", United European Gastroenterol J, 3, pp.325~334 (2015)
- Li H, "The 2 years’ long-term efficacy and safety of peroral endoscopic myotomy for the treatment of achalasia : a systematic review", J Cardiothorac Surg, 14, pp.1~ (2019)
- Li QL, "Outcomes of per-oral endoscopic myotomy for treatment of esophageal achalasia with a median follow-up of 49 months", Gastrointest Endosc, 87, pp.1405~1412.e3 (2018)
- Repici A, "GERD after per-oral endoscopic myotomy as compared with Heller’s myotomy with fundoplication : a systematic review with meta-analysis", Gastrointest Endosc, 87, pp.934~943.e18 (2018)
- Shimizu T, "Early experience with use of an endoscopic"hot"scissor-type knife for myotomy during per-oral endoscopic myotomy procedure", VideoGIE, 4, pp.182~184 (2019)