PMID- 31636782
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220410
IS  - 1918-3003 (Print)
IS  - 1918-3011 (Electronic)
IS  - 1918-3003 (Linking)
VI  - 11
IP  - 10
DP  - 2019 Oct
TI  - Management of Esophageal Achalasia in Quebec.
PG  - 682-689
LID - 10.14740/jocmr3963 [doi]
AB  - BACKGROUND: Esophageal achalasia is a defective relaxation of the lower 
      esophageal sphincter with a loss of esophageal peristalsis causing dysphagia. 
      Treatment can be Heller myotomy, pneumatic balloon dilation, Botox injections, 
      peroral endoscopic myotomy (POEM) or medical. The main objective of the study was 
      to measure the extent of post-treatment dysphagia depending on the type of 
      treatment. METHODS: This was a retrospective study conducted at the Centre 
      Hospitalier de l'Universite de Montreal (CHUM) between 2011 and 2017. All 
      patients with manometric diagnostic of achalasia in our department were included. 
      Data were collected with the electronic health record and a standardized 
      post-treatment telephone survey to evaluate the extent of dysphagia and the use 
      of proton pump inhibitor (PPI). RESULTS: A total of 169 patients were included. 
      The most frequent treatments were Heller myotomy (60%), Botox injection (18%) and 
      endoscopic balloon dilation (16%). There was a significant difference in the 
      management of patients treated at the CHUM and outside the CHUM for the frequency 
      of pneumatic dilation (28 vs. 7%; P = 0.001) and Heller myotomy (49 vs. 69%; P = 
      0.02). An Eckardt score </= 3 was found in 80% of patients. No significant score 
      difference was found between the CHUM and outside CHUM groups or between the 
      different treatments. The post-treatment use of PPI was of 49% and was not 
      significantly different depending on the site or the type of treatment. 
      CONCLUSION: Heller myotomy stays the most frequent treatment, especially outside 
      our tertiary center. The rate of post-treatment dysphagia is low no matter the 
      treatment choice. The use of PPI stays frequent regardless of the management site 
      or the type of treatment used.
CI  - Copyright 2019, Pouyez et al.
FAU - Pouyez, Catherine
AU  - Pouyez C
AD  - Centre Hospitalier de l'Universite de Montreal (CHUM), 1051 Sanguinet St., 
      Montreal, QC, Canada.
FAU - Neshkova, Elissaveta
AU  - Neshkova E
AD  - Centre Hospitalier de l'Universite de Montreal (CHUM), 1051 Sanguinet St., 
      Montreal, QC, Canada.
FAU - von Renteln, Daniel
AU  - von Renteln D
AD  - Centre Hospitalier de l'Universite de Montreal (CHUM), 1051 Sanguinet St., 
      Montreal, QC, Canada.
FAU - Bouin, Mickael
AU  - Bouin M
AD  - Centre Hospitalier de l'Universite de Montreal (CHUM), 1051 Sanguinet St., 
      Montreal, QC, Canada.
LA  - eng
PT  - Journal Article
DEP - 20191004
PL  - Canada
TA  - J Clin Med Res
JT  - Journal of clinical medicine research
JID - 101538301
PMC - PMC6785282
OTO - NOTNLM
OT  - Eckardt score
OT  - Esophageal achalasia
OT  - Management in Quebec
COIS- None to declare.
EDAT- 2019/10/23 06:00
MHDA- 2019/10/23 06:01
PMCR- 2019/10/04
CRDT- 2019/10/23 06:00
PHST- 2019/08/22 00:00 [received]
PHST- 2019/09/12 00:00 [accepted]
PHST- 2019/10/23 06:00 [entrez]
PHST- 2019/10/23 06:00 [pubmed]
PHST- 2019/10/23 06:01 [medline]
PHST- 2019/10/04 00:00 [pmc-release]
AID - 10.14740/jocmr3963 [doi]
PST - ppublish
SO  - J Clin Med Res. 2019 Oct;11(10):682-689. doi: 10.14740/jocmr3963. Epub 2019 Oct 
      4.