10th ESSD Congress, 2020

Dysphagia https://doi.org/10.1007/s00455-022-10457-x ABSTRACTS 10th ESSD Congress, 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature 2022 Abstracts without Session Assigned A Thousand and a Hundred Forty Peroral Endoscopic Myotomy for Esophageal Achalasia: 10 Years’ Experience from a Single Tertiary Center Tang, X; Chai, N; Linghu, E Conclusion: Our study demonstrated that POEM is a safe, and effective treatment for achalasia during a long-term follow-up. Further studies are warranted to compare the clinical outcomes of POEM with other treatment modalities. Efficacy and Safety of Peroral Endoscopic Myotomy for Achalasia in Adolescents and Young Adults: 10 Years’ Experiences from a Large Volume Center The First Medical Center of Chinese PLA General Hospital Introduction: Esophageal achalasia is most commonly treated with endoscopic dilation or laparoscopic Heller myotomy. Peroral endoscopic myotomy (POEM) has recently been described as a novel treatment for achalasia in humans. The aim of this study was to assess the clinical effectiveness and safety of POEM for treating esophageal achalasia performed in a single tertiary center within 10 years. Materials and Methods: Between June 2010 and May 2019, POEM was performed in 1140 consecutive patients with achalasia. POEM procedure consisted of the following step: firstly, submucosal tunnel was created and extended below the lower esophageal sphincter (LES) onto the gastric cardia after a mucosal incision was made; then endoscopic myotomy of circular muscle bundles was done; finally, the mucosal entry was closed by hemostatic clips. The Eckardt score and manometry were used to evaluate the outcomes. Results: POEM was successfully performed in 1115 of 1140 cases (97.8%). Mean procedure time was 42.1 min (range 33–86) and mean myotomy length was 9.5 cm (range 7–16). Mucosal perforations occurred in 23 (2%) patients during submucosal tunnel creation, major bleeding occurred in 15 (1.3%) patients, and 29 (2.5%) patients suffered pneumothorax immediate after procedure. All the complications were managed conservatively. During a mean follow-up period of 49.3 months (range 5–89 months), treatment success was achieved in 1005/1140 patients (88.2%). Mean LES pressure was 57.5 mmHg (29.2–83.1) and 15.6 mmHg (5.2–23.1) before and after the procedure (P = 0.000), respectively. Mean Eckardt score was 6.1 (4–11, median 6) and 0.6 (0–3, median 1) before and after POEM, respectively (P = 0.000). In a multivariate analysis, no independent predictor of treatment success was found. 215 patient (18.9%) developed mild reflux symptoms and required intermittent medication with proton pump inhibitors during the follow-up. Tang, X; Chai, N; Linghu, E The First Medical Center of Chinese PLA General Hospital Introduction: Data on peroral endoscopic myotomy (POEM) for achalasia in adolescents and young adults (AYA), especially with long-term follow-up, are rarely reported. This study was aimed to determine the long-term follow-up results of POEM for achalasia in AYA. Materials and Methods: A retrospective study was conducted in an academic, tertiary care, medical center, in which all AYA (aged 9–25 years) with achalasia undergoing POEM between February 2010 and January 2019 were identified from endoscopy databases. Data on demographics, perioperative parameters, and complications were collected and analyzed. Results: A total of 133 AYE (mean age 16.3 years) were enrolled. The subtypes of achalasia were type I-44, type II-79, type III-8, and unclassifed-2 based on Chicago classification. POEM was successfully performed in 129 of 133 cases (97%). The mean procedure time for the entire cohort was 52 min (range 45–84 min). No serious intraoperative and postoperative adverse events were encountered. During a mean follow-up time of 50.2 months (range 9–93 months), treatment success was achieved in 89.5% (119/133) patients. There was a significant improvement of symptoms relief (mean Eckardt score decreased from 7.3 to 0.8, P = 0.000) and LES pressure decrease (from 34.6 mm Hg to 12.3 mm Hg, P = 0.001) after POEM. Erosive esophagitis occurred in 14.8% (8/54) AYA. By 24-h pH test, GER was detected in 11.3% (6/32) patients. Conclusion: POEM is effective and safe in the AYA population, with the high rates of clinical success and low rates of complication during the long-term follow-up. 123 Abstract *Poster of Merit*: Peroral Endoscopic Myotomy is Effective and Safe in the Management of Esophageal Achalasia Regardless of Age Tang, X; Chai, N; Linghu, E The First Medical Center of Chinese PLA General Hospital Introduction: Peroral endoscopic myotomy (POEM) has emerged as a novel treatment choice for patients with esophageal achalasia, but the clinical efficacy and safety in patients with different age groups has not been well defined. Thus, we aimed to assess the effect of age on clinical outcomes for patients receiving POEM treatment. Materials and Methods: Demographic characteristics and clinical data were prospectively collected on patients undergoing POEM from 2010 to 2019. Patients were classified in three age group: group A (B 40 years), group B (40–70 years), and group C (C 70 years). Technical success, clinical success, adverse events and postoperative gastroesophageal reflux (GER) were compared and analyzed between the three groups. Results: A total of 1129 consecutive achalasia patients underwent POEM in our department, 461 (40.8%) in group A, 628 (55.6%) in group B, and 40 (3.5%) in group C. There were no significant differences of procedure time (56.3 ± 21.3 min vs 49.8 ± 21.5 min vs 61.2 ± 31.3 min, P = 1.000), intraoperative complications (1.5% vs 1.1% vs 1.8%, P = 1.000), and others parameters between the three groups. Technical success was achieved in 97.6% (450/461) patients of group A, 98.4% (618/628) of group B and 95% (38/40) of group C (P = 1.000). During the mean follow-up period of 50.1 months, clinical success rate (Eckardt score B 3) was similar between these three groups (90% vs 91.3% vs 89.5%, P = 1.000). Gastroesophageal reflux occurred in 20.2% patients of group A, 19.4% patients of group B and 18.6% patients of group C (P = 0.724). Conclusion: POEM can be performed in patients with different age safely, providing significant symptom relief. Advanced age should not to be considered as a contraindication to POEM. Peroral Endoscopic Myotomy (POEM) Versus Pneumatic Dilation (PD) for Achalasia: A Systematic Review and Meta-Analysis Tang, X1; Zhong, C2; Peng, Y2 1 The First Medical Center of Chinese PLA General Hospital; Affiliated Hospital of Southwest Medical University 2 Introduction: Presently, the primary endoscopic options for the treatment of achalasia are peroral endoscopic myotomy (POEM) and pneumatic dilation (PD). But the clinical outcomes of POEM and PD for achalasia have not yet to be fully evaluated. So we aimed to compare the clinical outcomes between the two treatment modality. Materials a (...truncated)