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Efficacy and Safety of Peroral Endoscopic Myotomy for Esophageal Achalasia and Achalasia-Related Diseases in Patients Aged 75 Years and Over

Peroral endoscopic myotomy (POEM) has become a popular treatment for esophageal achalasia and other esophageal motility disorders. However, its efficacy and safety in elderly patients are unclear. To clarify that, we reviewed the medical records of patients who underwent POEM in our hospital. A tota...

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Autores principales: Nakamura, Jun, Hikichi, Takuto, Hashimoto, Minami, Takasumi, Mika, Kato, Tsunetaka, Kobashi, Ryoichiro, Yanagita, Takumi, Suzuki, Rei, Sugimoto, Mitsuru, Sato, Yuki, Irie, Hiroki, Takagi, Tadayuki, Kobayakawa, Masao, Ohira, Hiromasa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700855/
https://www.ncbi.nlm.nih.gov/pubmed/34946392
http://dx.doi.org/10.3390/healthcare9121668
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author Nakamura, Jun
Hikichi, Takuto
Hashimoto, Minami
Takasumi, Mika
Kato, Tsunetaka
Kobashi, Ryoichiro
Yanagita, Takumi
Suzuki, Rei
Sugimoto, Mitsuru
Sato, Yuki
Irie, Hiroki
Takagi, Tadayuki
Kobayakawa, Masao
Ohira, Hiromasa
author_facet Nakamura, Jun
Hikichi, Takuto
Hashimoto, Minami
Takasumi, Mika
Kato, Tsunetaka
Kobashi, Ryoichiro
Yanagita, Takumi
Suzuki, Rei
Sugimoto, Mitsuru
Sato, Yuki
Irie, Hiroki
Takagi, Tadayuki
Kobayakawa, Masao
Ohira, Hiromasa
author_sort Nakamura, Jun
collection PubMed
description Peroral endoscopic myotomy (POEM) has become a popular treatment for esophageal achalasia and other esophageal motility disorders. However, its efficacy and safety in elderly patients are unclear. To clarify that, we reviewed the medical records of patients who underwent POEM in our hospital. A total of 11 patients who underwent POEM for esophageal achalasia (n = 10) and jackhammer esophagus (n = 1) were included. Procedural success, defined as the completion of an esophageal and gastric myotomy, was 100%. Clinical success, defined as an Eckardt score of 3 or less, without the use of additional treatments at 2 months, was 100%. The median Eckardt score significantly decreased after the POEM (baseline vs. 2 months after POEM; 7 (2–8) vs. 0 (0–1), p < 0.01). In the second and third years, the cumulative treatment effect maintenance rate was 88.9%. All patients taking antithrombotic agents had safe operations with the temporary discontinuation of these agents. There were four adverse events (two pneumoperitoneum, one mucosal injury, and one pneumonia), all of which improved with fasting or antibiotics. In conclusion, POEM is an effective and safe treatment for esophageal achalasia and achalasia-related diseases in patients aged 75 years and over.
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spelling pubmed-87008552021-12-24 Efficacy and Safety of Peroral Endoscopic Myotomy for Esophageal Achalasia and Achalasia-Related Diseases in Patients Aged 75 Years and Over Nakamura, Jun Hikichi, Takuto Hashimoto, Minami Takasumi, Mika Kato, Tsunetaka Kobashi, Ryoichiro Yanagita, Takumi Suzuki, Rei Sugimoto, Mitsuru Sato, Yuki Irie, Hiroki Takagi, Tadayuki Kobayakawa, Masao Ohira, Hiromasa Healthcare (Basel) Article Peroral endoscopic myotomy (POEM) has become a popular treatment for esophageal achalasia and other esophageal motility disorders. However, its efficacy and safety in elderly patients are unclear. To clarify that, we reviewed the medical records of patients who underwent POEM in our hospital. A total of 11 patients who underwent POEM for esophageal achalasia (n = 10) and jackhammer esophagus (n = 1) were included. Procedural success, defined as the completion of an esophageal and gastric myotomy, was 100%. Clinical success, defined as an Eckardt score of 3 or less, without the use of additional treatments at 2 months, was 100%. The median Eckardt score significantly decreased after the POEM (baseline vs. 2 months after POEM; 7 (2–8) vs. 0 (0–1), p < 0.01). In the second and third years, the cumulative treatment effect maintenance rate was 88.9%. All patients taking antithrombotic agents had safe operations with the temporary discontinuation of these agents. There were four adverse events (two pneumoperitoneum, one mucosal injury, and one pneumonia), all of which improved with fasting or antibiotics. In conclusion, POEM is an effective and safe treatment for esophageal achalasia and achalasia-related diseases in patients aged 75 years and over. MDPI 2021-12-01 /pmc/articles/PMC8700855/ /pubmed/34946392 http://dx.doi.org/10.3390/healthcare9121668 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nakamura, Jun
Hikichi, Takuto
Hashimoto, Minami
Takasumi, Mika
Kato, Tsunetaka
Kobashi, Ryoichiro
Yanagita, Takumi
Suzuki, Rei
Sugimoto, Mitsuru
Sato, Yuki
Irie, Hiroki
Takagi, Tadayuki
Kobayakawa, Masao
Ohira, Hiromasa
Efficacy and Safety of Peroral Endoscopic Myotomy for Esophageal Achalasia and Achalasia-Related Diseases in Patients Aged 75 Years and Over
title Efficacy and Safety of Peroral Endoscopic Myotomy for Esophageal Achalasia and Achalasia-Related Diseases in Patients Aged 75 Years and Over
title_full Efficacy and Safety of Peroral Endoscopic Myotomy for Esophageal Achalasia and Achalasia-Related Diseases in Patients Aged 75 Years and Over
title_fullStr Efficacy and Safety of Peroral Endoscopic Myotomy for Esophageal Achalasia and Achalasia-Related Diseases in Patients Aged 75 Years and Over
title_full_unstemmed Efficacy and Safety of Peroral Endoscopic Myotomy for Esophageal Achalasia and Achalasia-Related Diseases in Patients Aged 75 Years and Over
title_short Efficacy and Safety of Peroral Endoscopic Myotomy for Esophageal Achalasia and Achalasia-Related Diseases in Patients Aged 75 Years and Over
title_sort efficacy and safety of peroral endoscopic myotomy for esophageal achalasia and achalasia-related diseases in patients aged 75 years and over
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700855/
https://www.ncbi.nlm.nih.gov/pubmed/34946392
http://dx.doi.org/10.3390/healthcare9121668
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