Achalasia Achalasia Peroral endoscopic myotomy Esophageal motility disorders Gastroesophageal reflux
Conditions
Interventions
Anterior peroral endoscopic myotomy performed via a submucosal tunnel created on the anterior site( 2 o'
clock), with myotomy of the circular muscle fibers extending across the lower esophageal sphincter according to standard POEM technique,Posterior peroral endoscopic myotomy performed via a submucosal
clock), with myotomy of the circular muscle fibers extending across the lower esophageal sphincter according to standard POEM technique.
Experimental Procedure/Surgery,Experimental Procedure/Surgery
Anterior POEM,Posterior POEM
Sponsors
Faculty of Medicine Siriraj Hospital, Mahidol University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.primary achalasia diagnosed by timed barium esophagography (TBE) and high-resolution manometry (HRM)
Exclusion criteria
Exclusion criteria: 1.current or prior esophageal or gastric perforation 2.prior esophageal or gastric surgery 3.active esophagitis 4.esophageal malignancy 5.inability to tolerate sedated upper endoscopy 6.Reasons for intolerance included cardiopulmonary instability, severe pulmonary disease, cirrhosis with portal hypertension, varices, and/or ascites; other causes of portal hypertension 7.pregnancy or breastfeeding 8.active gastrointestinal bleeding. 9.Uncorrectable coagulopathy was defined as an international normalized ratio more than 1.5 or platelet count less than 50000 microliters
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Clinical success 12 months Improvement of Eckardt score,Esophageal acid exposure 3 months 24 hr pH monitoring | — |
Secondary
| Measure | Time frame |
|---|---|
| Procedure-related complications During hospitalization and follow-up Recorded intraoperative and postoperative complications,Lower esophageal sphincter pressure 12 months after POEM High-resolution manometry,Reflux esophagitis 12 months after POEM Esophagogastroduodenoscopy,POEM procedure During procedure Measured length of myotomy during procedure | — |
Countries
Thailand
Contacts
Public ContactChainarong Phalanusitthepha
Minimally Invasive Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
Outcome results
None listed