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Short-term safety and efficacy of peroral endoscopic myotomy for the treatment of achalasia in children
Background Peroral endoscopic myotomy (POEM) has shown excellent results for the treatment of achalasia in adults, but studies for children are limited. The study was aimed to analyze outcomes of peroral endoscopic myotomy (POEM) in children and compared with those in adults in a large multi-center...
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| Published in: | Journal of gastroenterology 2020-02, Vol.55 (2), p.159-168 |
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| container_end_page | 168 |
| container_issue | 2 |
| container_start_page | 159 |
| container_title | Journal of gastroenterology |
| container_volume | 55 |
| creator | Liu, Zuqiang Wang, Yun Fang, Ying Huang, Ying Yang, Hongbin Ren, Xiaoxia Xu, Meidong Chen, Shiyao Chen, Weifeng Zhong, Yunshi Zhang, Yiqun Qin, Wenzheng Hu, Jianwei Cai, Mingyan Yao, Liqing Li, Quanlin Zhou, Pinghong |
| description | Background
Peroral endoscopic myotomy (POEM) has shown excellent results for the treatment of achalasia in adults, but studies for children are limited. The study was aimed to analyze outcomes of peroral endoscopic myotomy (POEM) in children and compared with those in adults in a large multi-center study.
Methods
Records of consecutive patients with achalasia who underwent POEM at three tertiary centers were reviewed. A total of 130 children were included in this study. The primary outcomes of perioperative outcomes and clinical follow-up data were analyzed.
Results
One child (0.8%) experienced technical failure. Five children (3.8%) had major adverse events, including one with pneumothorax requiring drainage, two with delayed mucosa barrier failure, one with readmission, and one with vital-sign instability. Both post-POEM Eckardt score and median LES pressure were significantly lower than their pre-POEM reference values in children (0.7 vs 7.4; 7.0 vs 27.1 mmHg; both
P
0.05). Kaplan–Meier analysis showed that the risk of clinical failure was lower in children than adults (log-rank test, hazard ratio = 0.37, 95% confidence interval 0.15–0.91,
P
= 0.023).
Conclusions
POEM can be safely performed in children with achalasia, and produce a better clinical response during long-term follow-up compared with that in adults. |
| doi_str_mv | 10.1007/s00535-019-01607-4 |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2311920865</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714582976</galeid><sourcerecordid>A714582976</sourcerecordid><originalsourceid>FETCH-LOGICAL-c466t-4f80959338c2f2ab1df04211e53866aa1d899b8ab39c4752e15743ad3342013a3</originalsourceid><addsrcrecordid>eNp9kU2LFDEQhoMo7rj6BzxIwIuXXvOdznFZ_IIFD-o5ZNKVmSzdyZhkDv3vzTiriyISikDV875U8SL0kpIrSoh-WwmRXA6Eml6K6EE8Qhsqeksaxh6jDTFCDJRqcYGe1XpHCOVEjk_RBadKG6LUBu2-7HNpQ4Oy4OoCtBW7NGEIIXrnV5wDPkDJxc0Y0pSrz4fo8bLmlpcVh1xw2wNuBVxbILUT7_zeza5Gh2PCfh_nqUB6jp4EN1d4cf9fom_v3329-Tjcfv7w6eb6dvBCqTaIMBIjDeejZ4G5LZ0CEYxSkHxUyjk6jcZsR7flxgstGVCpBXcT54L16xy_RG_OvoeSvx-hNrvE6mGeXYJ8rJZxSg0jo5Idff0XepePJfXtOiUE191UP1A7N4ONKeRWnD-Z2mtNhRyZ0apTV_-g-ptgiT4nCLH3_xCws8CXXGuBYA8lLq6slhJ7Stee07U9XfszXSu66NX9xsftAtNvya84O8DPQO2jtIPycNJ_bH8ArpqtMg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2344373347</pqid></control><display><type>article</type><title>Short-term safety and efficacy of peroral endoscopic myotomy for the treatment of achalasia in children</title><source>Springer Nature</source><creator>Liu, Zuqiang ; Wang, Yun ; Fang, Ying ; Huang, Ying ; Yang, Hongbin ; Ren, Xiaoxia ; Xu, Meidong ; Chen, Shiyao ; Chen, Weifeng ; Zhong, Yunshi ; Zhang, Yiqun ; Qin, Wenzheng ; Hu, Jianwei ; Cai, Mingyan ; Yao, Liqing ; Li, Quanlin ; Zhou, Pinghong</creator><creatorcontrib>Liu, Zuqiang ; Wang, Yun ; Fang, Ying ; Huang, Ying ; Yang, Hongbin ; Ren, Xiaoxia ; Xu, Meidong ; Chen, Shiyao ; Chen, Weifeng ; Zhong, Yunshi ; Zhang, Yiqun ; Qin, Wenzheng ; Hu, Jianwei ; Cai, Mingyan ; Yao, Liqing ; Li, Quanlin ; Zhou, Pinghong</creatorcontrib><description>Background
Peroral endoscopic myotomy (POEM) has shown excellent results for the treatment of achalasia in adults, but studies for children are limited. The study was aimed to analyze outcomes of peroral endoscopic myotomy (POEM) in children and compared with those in adults in a large multi-center study.
Methods
Records of consecutive patients with achalasia who underwent POEM at three tertiary centers were reviewed. A total of 130 children were included in this study. The primary outcomes of perioperative outcomes and clinical follow-up data were analyzed.
Results
One child (0.8%) experienced technical failure. Five children (3.8%) had major adverse events, including one with pneumothorax requiring drainage, two with delayed mucosa barrier failure, one with readmission, and one with vital-sign instability. Both post-POEM Eckardt score and median LES pressure were significantly lower than their pre-POEM reference values in children (0.7 vs 7.4; 7.0 vs 27.1 mmHg; both
P
< 0.001). During a median follow-up time of 40 months, clinical reflux rate was 27.0% and clinical failure rates at 1, 3, and 5 years were 1.8%, 3.5%, and 4.4% for children. The technical failure, major adverse events, and postoperative clinical reflux were comparable between children and adults (all
P
> 0.05). Kaplan–Meier analysis showed that the risk of clinical failure was lower in children than adults (log-rank test, hazard ratio = 0.37, 95% confidence interval 0.15–0.91,
P
= 0.023).
Conclusions
POEM can be safely performed in children with achalasia, and produce a better clinical response during long-term follow-up compared with that in adults.</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-019-01607-4</identifier><identifier>PMID: 31679066</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Abdominal Surgery ; Achalasia ; Analysis ; Children ; Children's furniture ; Colorectal Surgery ; Drug therapy ; Endoscopy ; Gastroenterology ; Hepatology ; Medicine ; Medicine & Public Health ; Mucosa ; Original Article—Alimentary Tract ; Pneumothorax ; Rankings ; Surgical Oncology</subject><ispartof>Journal of gastroenterology, 2020-02, Vol.55 (2), p.159-168</ispartof><rights>Japanese Society of Gastroenterology 2019</rights><rights>COPYRIGHT 2020 Springer</rights><rights>Journal of Gastroenterology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-4f80959338c2f2ab1df04211e53866aa1d899b8ab39c4752e15743ad3342013a3</citedby><cites>FETCH-LOGICAL-c466t-4f80959338c2f2ab1df04211e53866aa1d899b8ab39c4752e15743ad3342013a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31679066$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Zuqiang</creatorcontrib><creatorcontrib>Wang, Yun</creatorcontrib><creatorcontrib>Fang, Ying</creatorcontrib><creatorcontrib>Huang, Ying</creatorcontrib><creatorcontrib>Yang, Hongbin</creatorcontrib><creatorcontrib>Ren, Xiaoxia</creatorcontrib><creatorcontrib>Xu, Meidong</creatorcontrib><creatorcontrib>Chen, Shiyao</creatorcontrib><creatorcontrib>Chen, Weifeng</creatorcontrib><creatorcontrib>Zhong, Yunshi</creatorcontrib><creatorcontrib>Zhang, Yiqun</creatorcontrib><creatorcontrib>Qin, Wenzheng</creatorcontrib><creatorcontrib>Hu, Jianwei</creatorcontrib><creatorcontrib>Cai, Mingyan</creatorcontrib><creatorcontrib>Yao, Liqing</creatorcontrib><creatorcontrib>Li, Quanlin</creatorcontrib><creatorcontrib>Zhou, Pinghong</creatorcontrib><title>Short-term safety and efficacy of peroral endoscopic myotomy for the treatment of achalasia in children</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background
Peroral endoscopic myotomy (POEM) has shown excellent results for the treatment of achalasia in adults, but studies for children are limited. The study was aimed to analyze outcomes of peroral endoscopic myotomy (POEM) in children and compared with those in adults in a large multi-center study.
Methods
Records of consecutive patients with achalasia who underwent POEM at three tertiary centers were reviewed. A total of 130 children were included in this study. The primary outcomes of perioperative outcomes and clinical follow-up data were analyzed.
Results
One child (0.8%) experienced technical failure. Five children (3.8%) had major adverse events, including one with pneumothorax requiring drainage, two with delayed mucosa barrier failure, one with readmission, and one with vital-sign instability. Both post-POEM Eckardt score and median LES pressure were significantly lower than their pre-POEM reference values in children (0.7 vs 7.4; 7.0 vs 27.1 mmHg; both
P
< 0.001). During a median follow-up time of 40 months, clinical reflux rate was 27.0% and clinical failure rates at 1, 3, and 5 years were 1.8%, 3.5%, and 4.4% for children. The technical failure, major adverse events, and postoperative clinical reflux were comparable between children and adults (all
P
> 0.05). Kaplan–Meier analysis showed that the risk of clinical failure was lower in children than adults (log-rank test, hazard ratio = 0.37, 95% confidence interval 0.15–0.91,
P
= 0.023).
Conclusions
POEM can be safely performed in children with achalasia, and produce a better clinical response during long-term follow-up compared with that in adults.</description><subject>Abdominal Surgery</subject><subject>Achalasia</subject><subject>Analysis</subject><subject>Children</subject><subject>Children's furniture</subject><subject>Colorectal Surgery</subject><subject>Drug therapy</subject><subject>Endoscopy</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mucosa</subject><subject>Original Article—Alimentary Tract</subject><subject>Pneumothorax</subject><subject>Rankings</subject><subject>Surgical Oncology</subject><issn>0944-1174</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kU2LFDEQhoMo7rj6BzxIwIuXXvOdznFZ_IIFD-o5ZNKVmSzdyZhkDv3vzTiriyISikDV875U8SL0kpIrSoh-WwmRXA6Eml6K6EE8Qhsqeksaxh6jDTFCDJRqcYGe1XpHCOVEjk_RBadKG6LUBu2-7HNpQ4Oy4OoCtBW7NGEIIXrnV5wDPkDJxc0Y0pSrz4fo8bLmlpcVh1xw2wNuBVxbILUT7_zeza5Gh2PCfh_nqUB6jp4EN1d4cf9fom_v3329-Tjcfv7w6eb6dvBCqTaIMBIjDeejZ4G5LZ0CEYxSkHxUyjk6jcZsR7flxgstGVCpBXcT54L16xy_RG_OvoeSvx-hNrvE6mGeXYJ8rJZxSg0jo5Idff0XepePJfXtOiUE191UP1A7N4ONKeRWnD-Z2mtNhRyZ0apTV_-g-ptgiT4nCLH3_xCws8CXXGuBYA8lLq6slhJ7Stee07U9XfszXSu66NX9xsftAtNvya84O8DPQO2jtIPycNJ_bH8ArpqtMg</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Liu, Zuqiang</creator><creator>Wang, Yun</creator><creator>Fang, Ying</creator><creator>Huang, Ying</creator><creator>Yang, Hongbin</creator><creator>Ren, Xiaoxia</creator><creator>Xu, Meidong</creator><creator>Chen, Shiyao</creator><creator>Chen, Weifeng</creator><creator>Zhong, Yunshi</creator><creator>Zhang, Yiqun</creator><creator>Qin, Wenzheng</creator><creator>Hu, Jianwei</creator><creator>Cai, Mingyan</creator><creator>Yao, Liqing</creator><creator>Li, Quanlin</creator><creator>Zhou, Pinghong</creator><general>Springer Singapore</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20200201</creationdate><title>Short-term safety and efficacy of peroral endoscopic myotomy for the treatment of achalasia in children</title><author>Liu, Zuqiang ; Wang, Yun ; Fang, Ying ; Huang, Ying ; Yang, Hongbin ; Ren, Xiaoxia ; Xu, Meidong ; Chen, Shiyao ; Chen, Weifeng ; Zhong, Yunshi ; Zhang, Yiqun ; Qin, Wenzheng ; Hu, Jianwei ; Cai, Mingyan ; Yao, Liqing ; Li, Quanlin ; Zhou, Pinghong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-4f80959338c2f2ab1df04211e53866aa1d899b8ab39c4752e15743ad3342013a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Achalasia</topic><topic>Analysis</topic><topic>Children</topic><topic>Children's furniture</topic><topic>Colorectal Surgery</topic><topic>Drug therapy</topic><topic>Endoscopy</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mucosa</topic><topic>Original Article—Alimentary Tract</topic><topic>Pneumothorax</topic><topic>Rankings</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Zuqiang</creatorcontrib><creatorcontrib>Wang, Yun</creatorcontrib><creatorcontrib>Fang, Ying</creatorcontrib><creatorcontrib>Huang, Ying</creatorcontrib><creatorcontrib>Yang, Hongbin</creatorcontrib><creatorcontrib>Ren, Xiaoxia</creatorcontrib><creatorcontrib>Xu, Meidong</creatorcontrib><creatorcontrib>Chen, Shiyao</creatorcontrib><creatorcontrib>Chen, Weifeng</creatorcontrib><creatorcontrib>Zhong, Yunshi</creatorcontrib><creatorcontrib>Zhang, Yiqun</creatorcontrib><creatorcontrib>Qin, Wenzheng</creatorcontrib><creatorcontrib>Hu, Jianwei</creatorcontrib><creatorcontrib>Cai, Mingyan</creatorcontrib><creatorcontrib>Yao, Liqing</creatorcontrib><creatorcontrib>Li, Quanlin</creatorcontrib><creatorcontrib>Zhou, Pinghong</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database (ProQuest)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Zuqiang</au><au>Wang, Yun</au><au>Fang, Ying</au><au>Huang, Ying</au><au>Yang, Hongbin</au><au>Ren, Xiaoxia</au><au>Xu, Meidong</au><au>Chen, Shiyao</au><au>Chen, Weifeng</au><au>Zhong, Yunshi</au><au>Zhang, Yiqun</au><au>Qin, Wenzheng</au><au>Hu, Jianwei</au><au>Cai, Mingyan</au><au>Yao, Liqing</au><au>Li, Quanlin</au><au>Zhou, Pinghong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Short-term safety and efficacy of peroral endoscopic myotomy for the treatment of achalasia in children</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>55</volume><issue>2</issue><spage>159</spage><epage>168</epage><pages>159-168</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><abstract>Background
Peroral endoscopic myotomy (POEM) has shown excellent results for the treatment of achalasia in adults, but studies for children are limited. The study was aimed to analyze outcomes of peroral endoscopic myotomy (POEM) in children and compared with those in adults in a large multi-center study.
Methods
Records of consecutive patients with achalasia who underwent POEM at three tertiary centers were reviewed. A total of 130 children were included in this study. The primary outcomes of perioperative outcomes and clinical follow-up data were analyzed.
Results
One child (0.8%) experienced technical failure. Five children (3.8%) had major adverse events, including one with pneumothorax requiring drainage, two with delayed mucosa barrier failure, one with readmission, and one with vital-sign instability. Both post-POEM Eckardt score and median LES pressure were significantly lower than their pre-POEM reference values in children (0.7 vs 7.4; 7.0 vs 27.1 mmHg; both
P
< 0.001). During a median follow-up time of 40 months, clinical reflux rate was 27.0% and clinical failure rates at 1, 3, and 5 years were 1.8%, 3.5%, and 4.4% for children. The technical failure, major adverse events, and postoperative clinical reflux were comparable between children and adults (all
P
> 0.05). Kaplan–Meier analysis showed that the risk of clinical failure was lower in children than adults (log-rank test, hazard ratio = 0.37, 95% confidence interval 0.15–0.91,
P
= 0.023).
Conclusions
POEM can be safely performed in children with achalasia, and produce a better clinical response during long-term follow-up compared with that in adults.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>31679066</pmid><doi>10.1007/s00535-019-01607-4</doi><tpages>10</tpages></addata></record> |
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| ispartof | Journal of gastroenterology, 2020-02, Vol.55 (2), p.159-168 |
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| language | eng |
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| source | Springer Nature |
| subjects | Abdominal Surgery Achalasia Analysis Children Children's furniture Colorectal Surgery Drug therapy Endoscopy Gastroenterology Hepatology Medicine Medicine & Public Health Mucosa Original Article—Alimentary Tract Pneumothorax Rankings Surgical Oncology |
| title | Short-term safety and efficacy of peroral endoscopic myotomy for the treatment of achalasia in children |
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