PMID- 33268035
OWN - NLM
STAT- MEDLINE
DCOM- 20220110
LR  - 20220110
IS  - 2210-741X (Electronic)
IS  - 2210-7401 (Linking)
VI  - 45
IP  - 4
DP  - 2021 Jul
TI  - The relationship between cardiac muscularis propria and clinical outcomes of 
      peroral endoscopic myotomy in achalasia.
PG  - 101529
LID - S2210-7401(20)30246-1 [pii]
LID - 10.1016/j.clinre.2020.08.007 [doi]
AB  - BACKGROUND AND AIM: Achalasia patients usually present lower esophageal sphincter 
      thickening, which can impact the expansibility of cardia. We aimed to investigate 
      the effect of cardiac muscularis propria (MP) on perioperative adverse events 
      (AEs) and treatment outcomes of patients treated with peroral endoscopic myotomy 
      (POEM). METHODS: We retrospectively reviewed 114 patients with achalasia 
      undergoing pre-POEM endoscopic ultrasonography (EUS) between May 2013 and 
      November 2019. Cardiac MP thickness was measured using EUS. POEM failure was 
      defined as Eckardt score >3. Risk factors for perioperative AEs and POEM failure 
      were identified. RESULTS: Patients were divided into the thin (n = 52) and the 
      thick group (n = 62) based on the median of cardiac MP thickness (3.0 mm). 
      Perioperative AEs rate of the thin group seemed to be slightly higher than that 
      of the thick group (11.5% vs. 4.8%, P = 0.30). During a median follow-up of 30 
      months (range 1-77), 100 patients completed follow-up, 16 (16%) of which occurred 
      clinical failure. The clinical outcomes of patients in the thin group were 
      significantly poorer than those patients in the thick group (P = 0.006). Cardiac 
      MP thickness was an independent risk factor for POEM failure (hazard ratio 3.9, 
      P = 0.02; Cox regression), but not the risk factor for perioperative AEs (odds 
      ratio 2.6, P = 0.2; logistic regression). CONCLUSION: Cardiac MP thickness could 
      be a novel predictive factor for POEM failure in patients with achalasia.
CI  - Copyright (c) 2020 Elsevier Masson SAS. All rights reserved.
FAU - He, Qing-Lin
AU  - He QL
AD  - Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China.
FAU - Chen, Xiu-Bing
AU  - Chen XB
AD  - Department of Gastroenterology, The First People's Hospital of Qinzhou, Qinzhou, 
      Guangxi Zhuang Autonomous Region 535000, PR China.
FAU - Lu, Dong-Hong
AU  - Lu DH
AD  - Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China.
FAU - Luo, Wei
AU  - Luo W
AD  - Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China.
FAU - Tao, Lin
AU  - Tao L
AD  - Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China.
FAU - Ning, Hong-Jian
AU  - Ning HJ
AD  - Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China.
FAU - Tang, Shao-Mei
AU  - Tang SM
AD  - Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China.
FAU - Peng, Yi-Ling
AU  - Peng YL
AD  - Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China.
FAU - Qin, Shan-Yu
AU  - Qin SY
AD  - Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China. 
      Electronic address: qsy0511@163.com.
FAU - Jiang, Hai-Xing
AU  - Jiang HX
AD  - Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China. 
      Electronic address: gxjianghx@163.com.
LA  - eng
PT  - Journal Article
DEP - 20201129
PL  - France
TA  - Clin Res Hepatol Gastroenterol
JT  - Clinics and research in hepatology and gastroenterology
JID - 101553659
SB  - IM
MH  - *Esophageal Achalasia/surgery
MH  - Esophageal Sphincter, Lower
MH  - Humans
MH  - *Myotomy
MH  - *Natural Orifice Endoscopic Surgery
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Achalasia
OT  - Endoscopic ultrasonography
OT  - Muscularis propria
OT  - Peroral endoscopic myotomy
EDAT- 2020/12/04 06:00
MHDA- 2022/01/11 06:00
CRDT- 2020/12/03 05:30
PHST- 2020/03/10 00:00 [received]
PHST- 2020/07/20 00:00 [revised]
PHST- 2020/08/19 00:00 [accepted]
PHST- 2020/12/04 06:00 [pubmed]
PHST- 2022/01/11 06:00 [medline]
PHST- 2020/12/03 05:30 [entrez]
AID - S2210-7401(20)30246-1 [pii]
AID - 10.1016/j.clinre.2020.08.007 [doi]
PST - ppublish
SO  - Clin Res Hepatol Gastroenterol. 2021 Jul;45(4):101529. doi: 
      10.1016/j.clinre.2020.08.007. Epub 2020 Nov 29.