Diseases of the Esophagus最新文献_第4页

Effect of benralizumab on histopathology and inflammatory signatures in a clinical cohort of eosinophilic esophagitis. 苯拉利珠单抗对嗜酸性粒细胞食管炎临床队列中组织病理学和炎症特征的影响

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae031

Ashley L Pyne, Amiko M Uchida, Mark W Hazel, Chris J Stubben, Joy W Chang, Dominique D Bailey, Nirmala Gonsalves, Kristina Allen-Brady, Kathryn A Peterson, Maria A Pletneva

{"title":"Effect of benralizumab on histopathology and inflammatory signatures in a clinical cohort of eosinophilic esophagitis.","authors":"Ashley L Pyne, Amiko M Uchida, Mark W Hazel, Chris J Stubben, Joy W Chang, Dominique D Bailey, Nirmala Gonsalves, Kristina Allen-Brady, Kathryn A Peterson, Maria A Pletneva","doi":"10.1093/dote/doae031","DOIUrl":"10.1093/dote/doae031","url":null,"abstract":"A preliminary report from the recent phase 3 trial of benralizumab, a monoclonal antibody that binds to interleukin-5 receptor alpha (IL5Rα), in patients with EoE revealed that medication use led to tissue eosinophil eradication but did not meet the clinical endpoint of symptom resolution. Here, we characterized the clinical, endoscopic, histologic, and transcriptional changes in patients with active EoE following benralizumab treatment. We retrospectively examined patients with EoE treated with benralizumab at the University of Utah (n = 11) and reviewed reported clinical symptoms, circulating and tissue eosinophilia, and endoscopic and histologic scores. Gene expression profiles from available esophageal tissue from benralizumab-treated patients were compared to those from patients with remission EoE (n = 5), active EoE (n = 10), and controls (n = 22). Benralizumab treatment resulted in partial symptom improvement and significant reduction in tissue eosinophilia, and endoscopic and histologic disease scoring (P < 0.01). Histologic score reductions were driven by eosinophil feature scores, while scores for epithelial features (basal cell hyperplasia and dilated intercellular spaces) were similar to those in active EoE. The gene signatures in benralizumab-treated patients mimicked those of active EoE (e.g. upregulation of POSTN, CDH26, CCL26, and downregulation of DSG1). RNA profiles and pathways support histologic findings of impaired epithelial function that persists despite benralizumab treatment. In conclusion, despite eosinophil eradication, patients treated with benralizumab had persistent epithelial injury at the histologic and transcriptional level. In this cohort, benralizumab therapy failed to eradicate inflammation and epithelial dysfunction showing that interleukin-5 receptor alpha blockade monotherapy is insufficient to control EoE.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correction to: In Memoriam Professor Dr. Jörg Rüdiger Siewert. 纠正：纪念教授博士Jörg rdiger Siewert。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-12-21 DOI: 10.1093/dote/doae119

引用次数: 0

Predictive factors for failure of neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy in esophageal squamous cell carcinoma. 食管鳞状细胞癌新辅助多西他赛、顺铂和5-氟尿嘧啶治疗失败的预测因素

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-12-19 DOI: 10.1093/dote/doae115

Masayoshi Terayama, Akihiko Okamura, Akira Oki, Kengo Kuriyama, Naoki Takahashi, Masahiro Tamura, Jun Kanamori, Shohei Udagawa, Keitaro Shimozaki, Hiroki Osumi, Shota Fukuoka, Mariko Ogura, Keisho Chin, Masayuki Watanabe

{"title":"Predictive factors for failure of neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy in esophageal squamous cell carcinoma.","authors":"Masayoshi Terayama, Akihiko Okamura, Akira Oki, Kengo Kuriyama, Naoki Takahashi, Masahiro Tamura, Jun Kanamori, Shohei Udagawa, Keitaro Shimozaki, Hiroki Osumi, Shota Fukuoka, Mariko Ogura, Keisho Chin, Masayuki Watanabe","doi":"10.1093/dote/doae115","DOIUrl":"https://doi.org/10.1093/dote/doae115","url":null,"abstract":"Recently, neoadjuvant chemotherapy comprising docetaxel, cisplatin, and 5-fluorouracil showed promising efficacy for esophageal squamous cell carcinoma. However, some patients do not achieve curative resection despite neoadjuvant chemotherapy using these drugs. This study aimed to clarify the pretherapeutic characteristics of these patients. We included 113 patients who underwent neoadjuvant chemotherapy with docetaxel, cisplatin, and 5-fluorouracil for potentially resectable esophageal squamous cell carcinoma and compared the clinical characteristics between patients who achieved curative resection (curative group) and those who failed to achieve curative resection after planned neoadjuvant chemotherapy (noncurative group). Moreover, we determined the factors predicting noncurative outcomes. Ninety-one (81%) and 22 patients (19%) were in the curative and noncurative groups, respectively. The noncurative group had significantly more tumors located in the upper third of the esophagus, larger-sized tumors, and borderline resectable tumors than the curative group (P = 0.003, 0.049, and <0.001, respectively). Moreover, the noncurative group had significantly higher serum squamous cell carcinoma antigen concentrations than the curative group (P = 0.008). Multivariable analysis identified tumor location in the upper third of the esophagus (odds ratio 7.31, P = 0.002), tumor size ≥50 mm (odds ratio 4.71, P = 0.037), and borderline resectable tumors (odds ratio 6.65, P = 0.003) as independent predictors for noncurative outcomes. Tumor location in the upper third of the esophagus, larger-sized tumors, and borderline resectable tumors might be significant predictors for noncurative outcomes in patients who received neoadjuvant chemotherapy with docetaxel, cisplatin, and 5-fluorouracil.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In Memoriam Professor Dr. Jörg Rüdiger Siewert. 纪念约尔格-吕迪格-西沃特博士教授。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-12-06 DOI: 10.1093/dote/doae107

Arnulf H Hölsche

引用次数: 0

Evaluation of patient satisfaction with an enhanced recovery protocol for esophageal resections: a concurrent quantitative and qualitative analysis. 评估食管切除术强化恢复方案的患者满意度：同步定量和定性分析。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae079

Johnny Moons, Hanne Declerck, Eveline Gijbels, Marleen Jans, Eva Puttevils, Toni Lerut, Philippe Nafteux, Theo Van Achterberg

{"title":"Evaluation of patient satisfaction with an enhanced recovery protocol for esophageal resections: a concurrent quantitative and qualitative analysis.","authors":"Johnny Moons, Hanne Declerck, Eveline Gijbels, Marleen Jans, Eva Puttevils, Toni Lerut, Philippe Nafteux, Theo Van Achterberg","doi":"10.1093/dote/doae079","DOIUrl":"10.1093/dote/doae079","url":null,"abstract":"Patient satisfaction during hospitalization for esophagectomy has been little studied. The aim of this study was to evaluate patients' satisfaction with a newly introduced enhanced recovery protocol (ERP) for esophagectomy. At hospital discharge, patients were invited to complete a questionnaire. This pseudonymized questionnaire contained 5-point Likert scales regarding items on multidisciplinary care (n = 7), information/communication (n = 7), length of stay (n = 1), and specific adaptations of care in the ERP (n = 11). One open question asked for patient experiences and suggestions for improving the ERP. Between May 2017 and December 2021, 521 patients were included in the ERP after esophagectomy. Of them, 327 patients (63%) completed the questionnaire. Response rates were evenly distributed between genders and slightly higher in younger patients (<60 years; 68%) as compared to elderly patients (>70 years; 60%). Quantitative analysis revealed high satisfaction rates for multidisciplinary care (86.8%), information/communication (84.9%), and ERP adaptations (82.2%), and length of stay was considered optimal in 80%. There were no significant differences in satisfaction observed between gender nor age groups. For the qualitative analysis, there were 108 open answers, resulting in 268 statements. Sentiments expressed in these statements were evaluated as negative, positive, or unspecified. Negative sentiments were attributable to alimentation, organizational factors, and communication. Positive sentiments were attributed to interpersonal relations, multidisciplinary care, and ERP. Overall, patients are very satisfied with the ERP for esophagectomy during hospitalization. By incorporating qualitative data, the results of this quantitative analysis are expanded and elucidated, showing areas where improvements to our ERP are possible to increase patient satisfaction.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The clinical utility of multidisciplinary team meetings for patients with complex benign upper gastrointestinal conditions. 多学科团队会议对复杂良性上消化道疾病患者的临床实用性。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae074

Matthew G R Allaway, Yuchen Luo, Hou Kiat Lim, Kiron Bhatia, Krinal Mori, Alex Craven, Ben Keong, Chek Heng Tog, Thomas Sweeney, Darren Wong, Michelle Goodwin, Christopher Leung, Ahmad Aly, Katheryn Hall, David S Liu

{"title":"The clinical utility of multidisciplinary team meetings for patients with complex benign upper gastrointestinal conditions.","authors":"Matthew G R Allaway, Yuchen Luo, Hou Kiat Lim, Kiron Bhatia, Krinal Mori, Alex Craven, Ben Keong, Chek Heng Tog, Thomas Sweeney, Darren Wong, Michelle Goodwin, Christopher Leung, Ahmad Aly, Katheryn Hall, David S Liu","doi":"10.1093/dote/doae074","DOIUrl":"10.1093/dote/doae074","url":null,"abstract":"Patients with benign upper gastrointestinal (UGI) conditions such as achalasia, gastroparesis and refractory gastroesophageal reflux disease often suffer from debilitating symptoms. These conditions can be complex and challenging to diagnose and treat, making them well suited for discussion within a multidisciplinary meeting (MDM). There is, however, a paucity of data describing the value of a benign UGI MDM. The aim of this study was to assess the impact of our unit's benign UGI MDM service and its outcomes. This was a retrospective analysis of prospectively collected data for all consecutive patients reviewed in the monthly benign UGI MDM between July 2021 and February 2024. The primary outcome was the incidence that MDM review changed clinical treatment. Secondary outcomes included change in diagnosis, additional investigations and referrals to subspecialists. A total of 104 patients met inclusion criteria. A total of 73 (70.2%) patients had a change in their overall management following MDM review; 25 (24.0%), 31 (29.8%) and 48 (46.2%) patients had changes in pharmacological, endoscopic and surgical interventions respectively. Most changes in pharmacological and endoscopic intervention involved treatment escalation, whereas most changes in surgical intervention involved treatment de-escalation. A total of 84 (80.8%) patients had a documented diagnosis post-MDM with 44 (42.3%) having a change in their pre-MDM diagnosis. 50 (48.1%) patients had additional investigation/s requested and 49 (47.1%) had additional referral pathway/s recommended. Over two thirds of patients had at least one aspect of their management plan changed following MDM review. These changes occurred across pharmacological, endoscopic, and surgical interventions.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimodal prehabilitation to enhance functional capacity of patients with esophageal cancer during concurrent neoadjuvant chemotherapies-a randomized feasibility trial. 在新辅助化疗期间通过多模式康复训练提高食道癌患者的功能--随机可行性试验。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae087

Jade St-Pierre, Miquel Coca-Martinez, Kenneth Drummond, Enrico Minnella, Agnihotram V Ramanakumar, Lorenzo Ferri, Franco Carli, Celena Scheede-Bergdahl

{"title":"Multimodal prehabilitation to enhance functional capacity of patients with esophageal cancer during concurrent neoadjuvant chemotherapies-a randomized feasibility trial.","authors":"Jade St-Pierre, Miquel Coca-Martinez, Kenneth Drummond, Enrico Minnella, Agnihotram V Ramanakumar, Lorenzo Ferri, Franco Carli, Celena Scheede-Bergdahl","doi":"10.1093/dote/doae087","DOIUrl":"10.1093/dote/doae087","url":null,"abstract":"Esophageal adenocarcinoma continues to bear high morbidity and mortality. Prehabilitation, using exercise, nutrition, and psychosocial strategies to optimize patients prior to surgical resection, is largely underexplored in this malignancy, especially in patients undergoing neoadjuvant chemotherapy. Objectives of this study were (i) to determine feasibility of prehabilitation during treatment in patients with esophageal cancer and (ii) to establish differences between hospital and home-based exercise. Patients were recruited from August 2019 - February 2023 and blindly randomized to either supervised or homebased exercise, receiving identical nutritional and psychosocial support. The main outcome measures were recruitment, retention, and dropout rates. The secondary outcomes included cardiorespiratory fitness, functional capacity, and quality of life. Forty-four subjects were blindly randomized: 23 to supervised exercise and 21 to home-based exercise (72% recruitment rate). Overall compliance for the supervised group was 72%; home-based group was 77%. Baseline to pre-operative, both groups experienced significant increases in sit-to-stand, arm curls, and amount of weekly moderate-vigorous physical activity. The home-based group experienced an additional considerable decrease in up-and-go test times. Both groups maintained cardiorespiratory fitness and saw substantial increases in some quality-of-life scores. Multimodal prehabilitation is feasible for patients with esophageal cancer undergoing neoadjuvant chemotherapy. In both groups, patient fitness, which is relevant for this patient population given the anticipated decline in functional status during this period, was maintained. This study provides a foundation for future prehabilitation interventions in this patient population.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of daytime and nighttime supine gastroesophageal reflux by pH monitoring of individuals with clinical suspicion of gastroesophageal reflux disease. 通过对临床怀疑患有胃食管反流病的人进行 pH 值监测，比较白天和夜间仰卧位胃食管反流情况。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae089

Filipe de Pádua, Fernando A M Herbella, Leonardo M Del Grande, Francisco Schlottmann, Marco G Patti

{"title":"Comparison of daytime and nighttime supine gastroesophageal reflux by pH monitoring of individuals with clinical suspicion of gastroesophageal reflux disease.","authors":"Filipe de Pádua, Fernando A M Herbella, Leonardo M Del Grande, Francisco Schlottmann, Marco G Patti","doi":"10.1093/dote/doae089","DOIUrl":"10.1093/dote/doae089","url":null,"abstract":"This study aims to compare pHmetric characteristics of diurnal and nocturnal supine reflux. We studied 500 consecutive individuals with clinical suspicion of gastroesophageal reflux disease (GERD) who underwent esophageal high-resolution manometry and prolonged ambulatory pH monitoring. Patients were classified with supine GERD pattern when the percentage of acid reflux time in the supine position was equal to or greater than 2.2%. Data on acid reflux in the supine position during daytime and nighttime recumbency were: (i) acid exposure time, (ii) number of reflux episodes, (iii) longest reflux episode, (iv) interval between the last meal and the supine position, (v) interval between the supine position and the first acid reflux episode, and (vi) reported symptoms. Of the 500 evaluated patients, 238 (48%) had GERD. Among these, supine pattern was observed in 134 (56%) patients, bipositional in 53 (23%), and orthostatic in 51 (21%). In patients with daytime recumbency, 112 (51% of 217) were pathological refluxers, with a mean DeMeester score of 45 ± 26. Total acid exposure time (P = 0.8) and reported Symptom Index (P = 0.2) did not differ depending on the period, whether diurnal or nocturnal. All other pHmetric parameters were lower during daytime recumbency. In conclusion, diurnal supine reflux has similar acid exposure time and temporal correlation between symptoms and reflux episodes as nocturnal supine reflux. Other pHmetric parameters are lower for diurnal supine reflux.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Paraconduit hiatus hernia after esophageal cancer surgery: incidence, risk factors, and management. 食管癌手术后的副食管裂孔疝：发病率、风险因素和处理方法。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae093

Rakesh Ahmed, Jessie A Elliott, Marcelle Blaser, Claire L Donohoe, Narayanasamy Ravi, John V Reynolds

{"title":"Paraconduit hiatus hernia after esophageal cancer surgery: incidence, risk factors, and management.","authors":"Rakesh Ahmed, Jessie A Elliott, Marcelle Blaser, Claire L Donohoe, Narayanasamy Ravi, John V Reynolds","doi":"10.1093/dote/doae093","DOIUrl":"10.1093/dote/doae093","url":null,"abstract":"In parallel with improved operative and oncologic outcomes for esophageal cancer, paraconduit hiatus hernia (PHH) is an increasingly recognized entity, both in the early postoperative phase and in long-term follow-up. The aim of this study was to assess the incidence of and risk factors for PHH, and to describe management approaches in a tertiary referral center. All patients undergoing surgery with curative intent for esophageal cancer from 2008 to 2022 at a single center were included. Early PHH was defined as occurring within three months of index surgery, with all other cases defined as late PHH. Surveillance computed tomography scans were undertaken among all disease-free patients to 5 years postoperatively. Kaplan Meier and Cox proportional hazards regression models were used to determine independent risk factors for PHH. Overall, 897 patients were studied. Totally, 62 patients (6.9%) developed PHH during follow-up. The 5-year survival-adjusted incidence of PHH was 9.7%. PHH was an asymptomatic radiologic finding in 45.5% of early and 84.3% of late cases (P = 0.070). Surgical intervention was required in 16 cases (25.8%), more commonly following early (63.6%) as compared with late PHH (17.6%, P < 0.01). Younger age (P < 0.039), initial transhiatal operative approach (P < 0.006) and extended resection of the crura (P < 0.001) were independently associated with increased risk of PHH on multivariable analysis. PHH was identified in almost 1 in 10 patients using surveillance imaging in long-term follow-up, independently associated with the transhiatal surgical approach and resection of crura, which raises consideration of prevention strategies. Surgical intervention is often required for patients with PHH presenting early after surgery, but many patients presenting with late PHH may be managed expectantly.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Standard length of peroral endoscopic myotomy (POEM) for achalasia: a systematic review and meta-analysis. 贲门失弛缓症口内镜下肌切开术（POEM）的标准长度：系统回顾和荟萃分析。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae069

Edoardo Vespa, Alberto Barchi, Francesco Vito Mandarino, Ernesto Fasulo, Maria Caterina Fratto, Sandro Passaretti, Francesco Azzolini, Edoardo Vincenzo Savarino, Silvio Danese

{"title":"Standard length of peroral endoscopic myotomy (POEM) for achalasia: a systematic review and meta-analysis.","authors":"Edoardo Vespa, Alberto Barchi, Francesco Vito Mandarino, Ernesto Fasulo, Maria Caterina Fratto, Sandro Passaretti, Francesco Azzolini, Edoardo Vincenzo Savarino, Silvio Danese","doi":"10.1093/dote/doae069","DOIUrl":"10.1093/dote/doae069","url":null,"abstract":"Peroral endoscopic myotomy (POEM) is an established treatment for achalasia, yet there is still a lack of technical standardization. No clear definition of 'long', 'standard', or 'short' POEM exists to date. We conducted a systematic review with meta-analysis to analyze current POEM length standards. We included studies reporting technical details of POEM, in which no definite or comparative myotomy length was intentionally adopted (standard myotomy). The primary outcome was the pooled mean total myotomy length. Sub-group analyses were performed to explore heterogeneity across studies. From the initial 7172 records, 31 studies with 3023 patients were included. Pooled mean of total myotomy length was 10.39 cm (95% CI 10.06-10.71; I2 99.3%). Pooled mean of esophageal and gastric myotomy length, provided by 17 studies, was 7.11 cm (95% CI 6.51-7.71; I2 99.8%) and 2.81 cm (95% CI 2.41-3-22; I2 99.8%), respectively. On subgroup analysis for achalasia subtypes, pooled mean length in non-spastic achalasia (type I and II) was 10.17 cm (95% CI 9.91-10.43; I2 94.2%), while in type III it was 14.02 cm (95% CI 10.59-17.44; I2 98.9%). Pooled mean myotomy length for studies conducted between 2014-2020 was 10.53 cm (95% CI, 10.22-10.84; I2 99.1%) and 9.74 cm (95% CI, 7.95-11.54; I2 99.7%) in 2021-2022. Myotomy length during a 'standard' POEM is 10.4 cm, remaining over 10 cm in non-spastic achalasia. The high heterogeneity across studies confirms that the POEM technique needs further standardization. We found no significant time trend towards adopting short POEM, despite recent evidence supporting its use.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0