Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand
- Author:
Tharathorn SUWATTHANARAK
1
;
Chainarong PHALANUSITTHEPA
;
Chatbadin THONGCHUAM
;
Thawatchai AKARAVIPUTH
;
Vitoon CHINSWANGWATANAKUL
;
Thikhamporn TAWANTANAKORN
;
Somchai LEELAKUSOLVONG
;
Monthira MANEERATTANAPORN
;
Piyaporn APISARNTHANARAK
;
Jitladda WASINRAT
Author Information
- Publication Type:Original Article
- From:Clinical Endoscopy 2024;57(5):610-619
- CountryRepublic of Korea
- Language:English
-
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.
