Long-term outcomes of peroral endoscopic myotomy for achalasia: a systematic review and meta-analysis.
Journal
Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
pubmed:
8
7
2022
medline:
31
1
2023
entrez:
7
7
2022
Statut:
ppublish
Résumé
The long-term outcomes of esophageal peroral endoscopic myotomy (POEM) are still unknown. We searched electronic databases (MEDLINE/PubMed, EMBASE, Scopus) for studies assessing outcomes after POEM for esophageal achalasia with a minimum median follow-up duration of 36 months. Pooled rates of clinical success and postoperative reflux were calculated and compared with the same values at 12/24/36 months when available. Subgroup analyses were performed to explore the interstudy heterogeneity. From 1528 initial records, 11 studies (2017-2021) were included. A total of 2342 patients (age 48.1 [SD 6.8] years; 50.1 % males) with a median follow-up of 48 months (interquartile range 45-60) were analyzed. The pooled clinical success rate was 87.3 % (95 %CI 83.6 %-91.0 %; Long-term clinical efficacy of POEM persisted in 87 % of patients with achalasia. Post-POEM symptomatic reflux remained stable over time. The risk for Barrett's esophagus and peptic strictures appeared minimal.
Sections du résumé
BACKGROUND
The long-term outcomes of esophageal peroral endoscopic myotomy (POEM) are still unknown.
METHODS
We searched electronic databases (MEDLINE/PubMed, EMBASE, Scopus) for studies assessing outcomes after POEM for esophageal achalasia with a minimum median follow-up duration of 36 months. Pooled rates of clinical success and postoperative reflux were calculated and compared with the same values at 12/24/36 months when available. Subgroup analyses were performed to explore the interstudy heterogeneity.
RESULTS
From 1528 initial records, 11 studies (2017-2021) were included. A total of 2342 patients (age 48.1 [SD 6.8] years; 50.1 % males) with a median follow-up of 48 months (interquartile range 45-60) were analyzed. The pooled clinical success rate was 87.3 % (95 %CI 83.6 %-91.0 %;
CONCLUSIONS
Long-term clinical efficacy of POEM persisted in 87 % of patients with achalasia. Post-POEM symptomatic reflux remained stable over time. The risk for Barrett's esophagus and peptic strictures appeared minimal.
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
167-175Commentaires et corrections
Type : CommentIn
Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
R. Maselli: consulting for Fujifilm, ERBE. P. Sharma: consultant for Medtronic, Olympus, Boston Scientific, Fujifilm, and Lumendi. He receives grant support from Ironwood, Erbe, Docbot, Cosmo pharmaceuticals, and CDx labs. C. Hassan: consulting fees from Fujifilm, Medtronic. A. Repici: consulting fees from Medtronic, Fujifilm, Boston Scientific, ERBE. All other authors declare that no conflicts of interest exist.