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Healthcare Utilization, Costs and Other Outcomes of Peroral Endoscopic Myotomy (POEM) Versus Heller Myotomy in the Inpatient Management of Achalasia in The United States: A 2016 to 2020 Nationwide Study 美国经口内窥镜肌切开术(POEM)与Heller肌切开术在贲门失弛缓症住院治疗中的医疗保健利用率、成本和其他结果:一项2016年至2020年的全国性研究

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-10-06 DOI: 10.1177/26345161231202957

Yassine Kilani, Mohammad Aldiabat, Maryam Mubashir, Saqr Alsakarneh, Ammar Arif Vohra, Yazan Aljabiri, Falak Hamo, Fnu Vikash, Vikash Kumar, Salih Samo

{"title":"Healthcare Utilization, Costs and Other Outcomes of Peroral Endoscopic Myotomy (POEM) Versus Heller Myotomy in the Inpatient Management of Achalasia in The United States: A 2016 to 2020 Nationwide Study","authors":"Yassine Kilani, Mohammad Aldiabat, Maryam Mubashir, Saqr Alsakarneh, Ammar Arif Vohra, Yazan Aljabiri, Falak Hamo, Fnu Vikash, Vikash Kumar, Salih Samo","doi":"10.1177/26345161231202957","DOIUrl":"https://doi.org/10.1177/26345161231202957","url":null,"abstract":"Introduction: Per-Oral Endoscopic Myotomy (POEM) is the recommended first-line treatment for all achalasia subtypes due to its minimally invasive nature. We aim to evaluate the trends of utilization, costs, and outcomes (mortality and complications) of POEM versus Heller Myotomy (HM) in U.S. hospitals. Methods: This is a retrospective study of individuals admitted with a primary diagnosis of achalasia. Data was obtained from Nationwide Inpatient Sample databases from the years 2016 to 2020 using ICD-10 codes. We assessed the therapeutic procedures employed, the trends and outcomes associated with POEM versus HM in terms of hospital utilization, mortality, morbidity, and the baseline characteristics of our study population. Results: A total of 26 880 adult individuals were diagnosed with achalasia. Of these, 11% underwent POEM, while 59% underwent HM. POEM rates increased from 6% to 10% of achalasia admissions, while HM decreased from 49% to 41% during the study period. No significant differences in total hospital charges or length of stay were observed between the 2 procedures. Regarding procedural complications, HM was associated with significantly reduced odds of pneumonia (adjusted Odds Ratio [aOR] = 0.09, 95% CI: 0.02-0.41), pneumoperitoneum (aOR = 0.11, 95% CI: 0.03-0.36), and pneumomediastinum (aOR = 0.21, 95% CI: 0.06-0.68), with no difference in the odds of esophageal perforation (aOR = 1.33, 95% CI: 0.27-6.48) and sepsis (aOR = 2.04, 95% CI: 0.22-18.40). Conclusion: While HM rates are currently declining in the U.S., POEM usage appears to be increasing. Despite being a less invasive measure than HM, POEM remains underutilized in the U.S.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135350619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Technical Considerations in Improving Delayed Gastric Conduit Emptying After Esophagectomy 改善食管切除术后胃导管延迟排空的技术考虑

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-09-29 DOI: 10.1177/26345161231202961

Nathan Alcasid, Jeffrey B. Velotta

引用次数: 0

Commentary on Medical Therapy for Ineffective Esophageal Motility: A Systematic Review—Surgical Considerations 食道动力不足的药物治疗综述:系统回顾-手术治疗的考虑

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-09-07 DOI: 10.1177/26345161231198623

Roger P. Tatum

引用次数: 0

Reflux Disease Questionnaire Scoring and Utilization: A Scoping Review 反流疾病问卷评分和使用:一项范围综述

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-09-07 DOI: 10.1177/26345161231198622

Alexander T. Reddy, S. Posner, Matthew Harbrecht, Nicholas Koutlas, Jonathan Reichstein, Sarah Cantrell, D. Leiman

{"title":"Reflux Disease Questionnaire Scoring and Utilization: A Scoping Review","authors":"Alexander T. Reddy, S. Posner, Matthew Harbrecht, Nicholas Koutlas, Jonathan Reichstein, Sarah Cantrell, D. Leiman","doi":"10.1177/26345161231198622","DOIUrl":"https://doi.org/10.1177/26345161231198622","url":null,"abstract":"The RDQ was developed to assist in diagnosing GERD, but is now widely used in multiple contexts and validated in several languages. However, there is no standard RDQ scoring rubric, making comparisons between its uses challenging. Therefore, we performed a scoping review to explore the current applications and scoring cutoffs of the RDQ. The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science electronic databases were systematically searched from January 2001 to January 2021 by a medical librarian using controlled vocabulary terms and keywords to identify experimental and observational study designs. The search strategy yielded 5707 studies and 116 met inclusion criteria yielding a total patient population of 115 064. Studies utilized the RDQ to establish a GERD diagnosis (n = 52, 45%), report the prevalence of GERD symptoms within a specific population (n = 21, 18%), and assess the effect of an intervention on symptoms (n = 43, 37%). There was variability between the scoring threshold used for diagnosing GERD, with total GERD domain score ≥12 being the most commonly used (n = 16, 14%). The RDQ was designed as an aid for diagnosing GERD, but scoring methods and thresholds vary and the RDQ now is used to describe the prevalence of GERD symptoms and to assess symptom response to intervention. Based on the current review, the use of RDQ appears best suited for comparing diagnostic or treatment cohorts in which symptoms are evaluated. Interpretation of RDQ findings outside of a study-specific context is limited without accepted scoring standards.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41372212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Screening for Esophageal Squamous Cell Carcinoma: A Review 食管鳞状细胞癌筛查研究进展

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-09-07 DOI: 10.1177/26345161231198626

S. Kodaganur Gopinath, S. Jiwnani

{"title":"Screening for Esophageal Squamous Cell Carcinoma: A Review","authors":"S. Kodaganur Gopinath, S. Jiwnani","doi":"10.1177/26345161231198626","DOIUrl":"https://doi.org/10.1177/26345161231198626","url":null,"abstract":"Esophageal cancer is amongst the most common types of cancer in Asia. It is a deadly disease where incidence almost parallels mortality. It is of 2 major subtypes, adenocarcinoma being more common in the global north and squamous cell carcinoma being more common in the global south. China, Japan, India, Iran, and other Asian countries contribute to roughly 80% of the global disease burden. Fortunately, esophageal squamous cell cancers (ESCC) are also amenable for screening. Natural history studies have shown that severe dysplasia carries the highest risk of progression to ESCC. Early detection has shown to be extremely beneficial, with cure rates above 90% for precursor lesions and early-stage esophageal cancer. There are various modalities available for screening—Chinese balloon cytology is a low cost technique that can be applied for mass screening but has only moderate sensitivity (39%-62%). Recent studies have demonstrated that using methylated DNA markers and applying artificial intelligence technology can significantly improve the yield of cytology. Lugol’s chromo-endoscopy has been demonstrated to have good sensitivity and specificity (>85%), but is an invasive technique and requires operator expertise. Other image enhancing techniques such as narrow-band imaging, autofluorescence, endocytoscopy and micro-endoscopy are promising, but currently not cost effective for mass screening. There are 3 large randomized trials underway in China, initial published results have demonstrated a detection rate between 0.7% to 1.2% for ESCC and 4% to 6% for pre cursor lesions. These trials, with some of them involving >100 000 patients have demonstrated the feasibility of endoscopic screening, but long term results are awaited.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48561016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Critical Decision Making: Technical Aspects of Esophageal Ablation 关键决策:食道消融的技术方面

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-09-01 DOI: 10.1177/26345161231198617

Felice Schnoll-Sussman

引用次数: 0

Topic: Endoscopic Foregut Surgery (Including Endobariatrics)Abstract ID: 82A Retrospective Chart Review of 79 Patients Undergoing the Refluxstop™ Procedure to Manage Gastroesophageal Reflux Disease: Safety and Efficacy 摘要:82A回顾性分析79例接受reffluxstop™治疗胃食管反流病的患者:安全性和有效性

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-09-01 DOI: 10.1177/26345161231196002

Thorsten Lehmann, Mantas Simkus, Christoph Oehler

引用次数: 0

Topic: Education/Training Abstract ID: 18 The Efficacy and Yield of Routine Duodenal Biopsy Sampling and Histopathological Analysis Versus Endoscopic Gestalt for the Diagnostic Evaluation of Celiac Disease in Patients With Normal Endoscopic Findings: An Experience at a Tertiary Care Center 主题:教育/培训摘要:18常规十二指肠活检取样和组织病理学分析与内镜下完形检查对乳糜泻诊断评估的效果和收益:在三级保健中心的经验

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-09-01 DOI: 10.1177/26345161231189086

Clive Miranda, Murad Ali, Muddasir Ayaz, Gregory Gudleski, Thomas Mahl

引用次数: 0

Topic: Stomach Abstract ID: 73 Surgical Treatment of Median Arcuate Ligament Syndrome in a Series of Patients With Gastroparesis 摘要:73胃轻瘫患者正中弓状韧带综合征的手术治疗

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-09-01 DOI: 10.1177/26345161231195985

Brittany Harper, Gian Galura, Gilbert Aidinian, Richard McCallum, Brian Davis

引用次数: 0

Topic: InternationalAbstract ID: 70Transverse Mucosal Incision for POEM: Reducing Procedure Time and Clip Usage 主题:国际摘要ID: 70横向粘膜切口诗:减少手术时间和夹子的使用

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-09-01 DOI: 10.1177/26345161231195981

Alejandro Nieponice, Hugo Delle Donne, Mauricio Ramirez, David Solinas, Fabio Nachman, Adolfo Badaloni

引用次数: 0