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논문 기본 정보

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저자정보
Hélène Foisy (Université de Lyon Hospices Civils de Lyon Gastroenterology Hopital E Herriot Lyon France) Mathieu Pioche (Université de Lyon Hospices Civils de Lyon Gastroenterology Hopital E Herriot Lyon France) Edouard Chabrun (Université de Bordeaux CHU de Bordeaux Gastroenterology Hôpital Haut Leveque Pessac France) Thierry Ponchon (Université de Lyon Hospices Civils de Lyon Gastroenterology Hopital E Herriot Lyon France) Frank Zerbib (Université de Bordeaux CHU de Bordeaux Gastroenterology Hôpital Haut Leveque Pessac France) Jérôme Rivory (Université de Lyon Hospices Civils de Lyon Gastroenterology Hopital E Herriot Lyon France) François Mion (Université de Lyon Lyon I University Digestive Physiology Lyon France) Sabine Roman (Université de Lyon Lyon I University Digestive Physiology Lyon France)
저널정보
대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.26 No.2
발행연도
2020.1
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204 - 214 (11page)

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Background/AimsPeroral endoscopy myotomy (POEM) is effective to treat achalasia. We aim to determine POEM effect on esophageal function and search for predictive factors of response to POEM and co-occurrence of gastroesophageal reflux disease (GERD). MethodsA total of 64 untreated achalasia patients who underwent high-resolution manometry (HRM) before and 3 months after POEM were retrospectively included. Response to treatment was defined as an Eckardt score < 3. Reflux symptoms and patient’s satisfaction were evaluated. Data were compared using paired t test, Chi-square test or log rank test. ResultsThe 2-year success rate in response to POEM was 90%. All responders reported being satisfied while only 33% of non-responders did (P < 0.001) and 64% of patients with reflux symptoms were satisfied versus 96% of those without (P = 0.009). On HRM, the integrated relaxation pressure and the contractile pattern changed significantly after POEM but were not predictive of response. Between pre and post POEM HRM, a decrease in maximal esophageal pressurization during rapid drink challenge (RDC) was associated with a better response rate than an increase of pressurization (91% vs 50%, P = 0.004). As evidenced by pH monitoring performed after POEM, GERD was pathological or borderline in 50% of patients (18/36) while only 19% (11/59) reported clinically significant reflux symptoms. On post POEM HRM, maximal esophageal pressurization during RDC was lower in patients with pathological or borderline GERD compared to those without (P = 0.054). ConclusionsEsophageal HRM parameters changed significantly after POEM. Maximal esophageal pressurization during RDC may be useful to predict outcome.
#Esophageal achalasia #Gastroesophageal reflux #Manometry #Myotomy

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참고문헌 (41)

참고문헌 신청
Boeckxstaens GE / 2014 / Achalasia / Lancet 383:83~93 google schola Pandolfino JE / 2008 / Achalasia : a new clinically relevant classification by high-resolution manometry / Gastroenterology 135:1526~1533 google schola Roman S / 2016 / High-resolution manometry improves the diagnosis of esophageal motility disorders in patients with dysphagia : a randomized multicenter study / Am J Gastroenterol 111:372~380 google schola Kahrilas PJ / 2015 / The Chicago classification of esophageal motility disorders, v3.0 / Neurogastroenterol Motil 27:160~174 google schola Rohof WO / 2013 / Outcomes of treatment for achalasia depend on manometric subtype / Gastroenterology 144:718~725 google schola

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