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Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand. | LitMetric

AI Article Synopsis

  • Achalasia is a rare esophageal disease that can be treated with peroral endoscopic myotomy (POEM), but recurrence is a concern; this study investigates predictive tools for recurrence using timed barium esophagography (TBE).
  • The study included 30 patients who underwent POEM and categorized them into discordant (improved Eckardt score but little change in TBE) and concordant (both improved) groups, finding that the discordant group had a much higher recurrence rate.
  • The findings indicate that using both the Eckardt score and TBE together can effectively predict the risk of recurrence in achalasia patients post-POEM, highlighting the importance of monitoring these factors.

Article Abstract

Background/aims: Achalasia is a rare esophageal motility disease, for which peroral endoscopic myotomy (POEM) has emerged as a promising treatment option; however, recurrence remains a challenge. Timed barium esophagography (TBE) is a useful diagnostic tool and potential outcome predictor of achalasia. This study aimed to determine predictive tools for recurrence after POEM.

Methods: This retrospective study enrolled achalasia patients who underwent POEM between January 2015 and December 2021. Patients were categorized into two groups using the 1-month post-POEM Eckardt scores and TBE: the discordant group (Eckardt score improved >50%, TBE decreased <50%) and the concordant group (both Eckardt score and TBE improved >50%). Recurrence was defined as a reincrease in the Eckardt score to more than three during follow-up.

Results: Complete medical records were available in 30 patients who underwent POEM. Seventeen patients (56.7%) were classified into the discordant group, while 13 patients (43.3%) were in the concordant group. The overall recurrence rate was 11.9% at 1-year, increasing to 23.8% during the extended follow-up. The discordant group had a 6.87 fold higher recurrence rate than the concordant group (52.9% vs. 7.7%, p=0.017).

Conclusions: These results strongly suggest that combining the Eckardt score with TBE can effectively predict recurrent achalasia after POEM. Patients in the discordant group had an elevated risk.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11474463PMC
http://dx.doi.org/10.5946/ce.2023.236DOI Listing

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