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01.02.2023 | Original Article

Peroral Endoscopic Myotomy for Achalasia in Older Adults: A Retrospective Analysis of 39 Cases with a Minimum Follow-Up of 5 Years

verfasst von: Dongzi Peng, Yuyong Tan, Si Yang, Mei Zhou, Liang Lv, Chengbai Liang, Hongyi Zhu, Rong Li, Deliang Liu

Erschienen in: Dysphagia | Ausgabe 5/2023

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Abstract

Peroral endoscopic myotomy (POEM) has demonstrated favorable short-term safety and efficacy in older adults, while a comprehensive understanding of the long-term outcomes were vague. We aimed to evaluate clinical outcomes in older adults’ 5-year postop after undergoing POEM to treatment achalasia. Older adults from a single hospital who received POEM between January 2010 and January 2017 were analyzed. Older persons were reached to evaluate their symptoms at present and encouraged repeat examinations for objective follow-up. The clinical success, POEM-related indicators, POEM-related adverse events, and quality of life were assessed. Thirty-nine older adults with a mean age of 70.82 ± 4.72 who underwent POEM were studied at a mean 84.23 ± 25.06 month follow-up. The preoperative diagnosis was achalasia type I in 7 older adults, achalasia type II in 26 older adults, and achalasia type III in 2 older adults. Sixteen older adults had prior treatment and 21 older adults suffered from comorbidities. The median operative time was 50 (25–120) minutes, and perioperative adverse events were recorded in four older adults. The current Eckardt scores were significantly lower than that before POEM (2.08 ± 2.12 vs. 6.58 ± 1.78, P < 0.001). Besides, long-term clinical success was gained in 66.7% of older adults. Three older adults received postop treatment for symptom recurrence. Ultimately, 80.6% of old adults expressed satisfaction with POEM, while 27.8% of older adults suffered from symptomatic reflux. In conclusion, POEM can provide symptomatic improvement in a large proportion of older adults with achalasia at 5-year postop.

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Titel: Peroral Endoscopic Myotomy for Achalasia in Older Adults: A Retrospective Analysis of 39 Cases with a Minimum Follow-Up of 5 Years
verfasst von: Dongzi Peng
Yuyong Tan
Si Yang
Mei Zhou
Liang Lv
Chengbai Liang
Hongyi Zhu
Rong Li
Deliang Liu
Publikationsdatum: 01.02.2023
Verlag: Springer US
Erschienen in: Dysphagia / Ausgabe 5/2023
Print ISSN: 0179-051X
Elektronische ISSN: 1432-0460
DOI: https://doi.org/10.1007/s00455-023-10554-5

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