| Strategic International Session1（W）(JGES・JSGE・JSGCS) |
| Thu. October 31st 14:30 - 17:00 Room 9: Portopia Hotel Main Building Kairaku 3 |
| Long-term Efficacy of Redo Peroral Endoscopic Myotomy in Achalasia Patients With Recurrence After Surgical Treatment | |||
| Mamoru Ito1, Takahiro Masuda2, Kazuki Sumiyama1 | |||
| 1Department of Endoscopy, The Jikei University School of Medicine, 2Department of Surgery, The Jikei University School of Medicine | |||
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| Background: Previous studies demonstrate short-term effectiveness of redo peroral endoscopic myotomy (POEM) for achalasia with recurrent symptoms after surgical treatment, but long-term results are less known. Aim: To assess the long-term outcomes of redo POEM in achalasia patients with recurrent symptoms after previous surgical treatment. Methods: A single-center, retrospective analysis of achalasia patients who underwent redo POEM between January 2016 and December 2022 was performed. The primary outcome was clinical success, defined as Eckardt symptom score of 3 or less without additional interventions. Secondary outcomes included postoperative changes in Eckardt symptom score and gastroesophageal reflux disease (GERD). Results: A total of 24 patients were included. Previous surgeries included nineteen Heller-myotomy, one gastric valvuloplasty, and four unknown procedures. Thirteen (54.2%) patients had a sigmoid esophagus. The median esophageal transverse diameter was 4.5 cm (range 1.8-9.2 cm). Manometric types were Type I:11, II:0, III:3, and Unknown:10 on Chicago classification v4.0. Median total myotomy length was 12 (range 7-27) cm. The median follow-up period was 39 months. The Kaplan-Meier analysis revealed a clinical success rate of 94.7% at 48 months. Two patients required additional procedures. The median Eckardt score decreased from 5 (range 2-9) to 1 (0-7) after redo POEM (p<0.05). Postoperative GERD was observed in 12 cases (50.0%). Conclusions: Redo POEM for achalasia patients with previously failed surgical procedures demonstrated favorable long-term efficacy. |
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Index Term 1: Achalasia Index Term 2: Peroral endoscopic myotomy |
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