PMID- 28472834
OWN - NLM
STAT- MEDLINE
DCOM- 20180419
LR  - 20220330
IS  - 1438-8812 (Electronic)
IS  - 0013-726X (Linking)
VI  - 49
IP  - 7
DP  - 2017 Jul
TI  - Gastroesophageal reflux after peroral endoscopic myotomy: a multicenter 
      case-control study.
PG  - 634-642
LID - 10.1055/s-0043-105485 [doi]
AB  - Background and study aims The variables associated with gastroesophageal reflux 
      (GER) after peroral endoscopic myotomy (POEM) are largely unknown. This study 
      aimed to: 1) identify the prevalence of reflux esophagitis and asymptomatic GER 
      in patients who underwent POEM, and 2) evaluate patient and intraprocedural 
      variables associated with post-POEM GER. Patients and methods All patients who 
      underwent POEM and subsequent objective testing for GER (pH study with or without 
      upper gastrointestinal [GI] endoscopy) at seven tertiary academic centers (one 
      Asian, two US, four European) were included. Patients were divided into two 
      groups: 1) DeMeester score >/= 14.72 (cases) and 2) DeMeester score of < 14.72 
      (controls). Asymptomatic GER was defined as a patient with a DeMeester score 
      >/= 14.72 who was not consuming proton pump inhibitor (PPI). Results A total of 282 
      patients (female 48.2 %, Caucasian 84.8 %; mean body mass index 24.1 kg/m(2)) 
      were included. Clinical success was achieved in 94.3 % of patients. GER 
      evaluation was completed after a median follow-up of 12 months (interquartile 
      range 10 - 24 months). A DeMeester score of >/= 14.72 was seen in 57.8 % of 
      patients. Multivariable analysis revealed female sex to be the only independent 
      association (odds ratio 1.69, 95 % confidence interval 1.04 - 2.74) with 
      post-POEM GER. No intraprocedural variables were associated with GER. Upper GI 
      endoscopy was available in 233 patients, 54 (23.2 %) of whom were noted to have 
      reflux esophagitis (majority Los Angeles Grade A or B). GER was asymptomatic in 
      60.1 %. Conclusion Post-POEM GER was seen in the majority of patients. No 
      intraprocedural variables were identified to allow for potential alteration in 
      procedural technique.
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Kumbhari, Vivek
AU  - Kumbhari V
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, 
      Maryland, United States.
FAU - Familiari, Pietro
AU  - Familiari P
AD  - Digestive Endoscopy Unit, Catholic University, Gemelli University Hospital, Rome, 
      Italy.
FAU - Bjerregaard, Niels Christian
AU  - Bjerregaard NC
AD  - Department of Surgical Gastroenterology, Aarhus University Hospital, Aarhus, 
      Denmark.
FAU - Pioche, Mathieu
AU  - Pioche M
AD  - Gastroenterologie, Pavillon H Hopital Edouard Herriot, Lyon, France.
FAU - Jones, Edward
AU  - Jones E
AD  - Division of General and Gastrointestinal Surgery, The Ohio State University 
      Wexner Medical Center, Columbus, Ohio, United States.
FAU - Ko, Weon Jin
AU  - Ko WJ
AD  - Department of Gastroenterology, CHA Bundang Medical Center, Seongnam, Korea.
FAU - Hayee, Bu
AU  - Hayee B
AD  - Gastroenterology, King's College Hospital, London, United Kingdom.
FAU - Cali, Anna
AU  - Cali A
AD  - Digestive Endoscopy Unit, Catholic University, Gemelli University Hospital, Rome, 
      Italy.
FAU - Ngamruengphong, Saowanee
AU  - Ngamruengphong S
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, 
      Maryland, United States.
FAU - Mion, Francois
AU  - Mion F
AD  - Gastroenterologie, University of Lyon, Lyon, France.
FAU - Hernaez, Ruben
AU  - Hernaez R
AD  - Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, 
      United States.
AD  - Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, United 
      States.
FAU - Roman, Sabine
AU  - Roman S
AD  - Gastroenterologie, Pavillon H Hopital Edouard Herriot, Lyon, France.
FAU - Tieu, Alan H
AU  - Tieu AH
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, 
      Maryland, United States.
FAU - El Zein, Mohamad
AU  - El Zein M
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, 
      Maryland, United States.
FAU - Ajayi, Tokunbo
AU  - Ajayi T
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, 
      Maryland, United States.
FAU - Haji, Amyn
AU  - Haji A
AD  - Gastroenterology, King's College Hospital, London, United Kingdom.
FAU - Cho, Joo Young
AU  - Cho JY
AD  - Department of Gastroenterology, CHA Bundang Medical Center, Seongnam, Korea.
FAU - Hazey, Jeffrey
AU  - Hazey J
AD  - Division of General and Gastrointestinal Surgery, The Ohio State University 
      Wexner Medical Center, Columbus, Ohio, United States.
FAU - Perry, Kyle A
AU  - Perry KA
AD  - Division of General and Gastrointestinal Surgery, The Ohio State University 
      Wexner Medical Center, Columbus, Ohio, United States.
FAU - Ponchon, Thierry
AU  - Ponchon T
AD  - Gastroenterologie, Pavillon H Hopital Edouard Herriot, Lyon, France.
FAU - Kunda, Rastislav
AU  - Kunda R
AD  - Department of Surgical Gastroenterology, Aarhus University Hospital, Aarhus, 
      Denmark.
FAU - Costamagna, Guido
AU  - Costamagna G
AD  - Digestive Endoscopy Unit, Catholic University, Gemelli University Hospital, Rome, 
      Italy.
AD  - IHU-USIAS, University of Strasbourg, France.
FAU - Khashab, Mouen A
AU  - Khashab MA
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, 
      Maryland, United States.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20170504
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
SB  - IM
CIN - Endoscopy. 2017 Jul;49(7):625-628. PMID: 28658688
CIN - Endoscopy. 2017 Jul;49(7):726. PMID: 28658695
CIN - Endoscopy. 2017 Dec;49(12):1282. PMID: 29186734
CIN - Endoscopy. 2017 Dec;49(12):1283. PMID: 29186735
CIN - Endoscopy. 2017 Dec;49(12):1284. PMID: 29186736
MH  - Adult
MH  - Aged
MH  - Asia/epidemiology
MH  - Asymptomatic Diseases
MH  - Case-Control Studies
MH  - Endoscopy, Gastrointestinal/adverse effects
MH  - Esophageal Achalasia/surgery
MH  - Esophageal Sphincter, Lower/*surgery
MH  - Esophagitis, Peptic/*etiology
MH  - Europe/epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Gastroesophageal Reflux/*epidemiology/*etiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myotomy/*adverse effects/methods
MH  - Postoperative Complications/epidemiology/etiology
MH  - Prevalence
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Sex Factors
MH  - United States/epidemiology
COIS- Competing interests: Dr. Khashab is a consultant for Boston Scientific and 
      Olympus America, and has received research support from Cook Medical. Dr Kumbhari 
      is a consultant for Boston Scientific and Apollo Endosurgery.
EDAT- 2017/05/05 06:00
MHDA- 2018/04/20 06:00
CRDT- 2017/05/05 06:00
PHST- 2017/05/05 06:00 [pubmed]
PHST- 2018/04/20 06:00 [medline]
PHST- 2017/05/05 06:00 [entrez]
AID - 10.1055/s-0043-105485 [doi]
PST - ppublish
SO  - Endoscopy. 2017 Jul;49(7):634-642. doi: 10.1055/s-0043-105485. Epub 2017 May 4.