Gastroesophageal reflux after peroral endoscopic myotomy: a multicenter case–control study

Vivek Kumbhari, Pietro Familiari, Niels Christian Bjerregaard, Mathieu Pioche, Edward Jones, Weon Jin Ko, Bu Hayee, Anna Cali, Saowanee Ngamruengphong, Francois Mion, Ruben Hernaez, Sabine Roman, Alan H. Tieu, Mohamad El Zein, Tokunbo Ajayi, Amyn Haji, Joo Young Cho, Jeffrey Hazey, Kyle A. Perry, Thierry PonchonRastislav Kunda, Guido Costamagna, Mouen Khashab

Research output: Contribution to journalArticle

Abstract

Background and study aims The variables associated with gastroesophageal reflux (GER) after peroral endoscopic myotomy (POEM) are largely unknown. This study aimed to: 1) identify the prevalence of reflux esophagitis and asymptomatic GER in patients who underwent POEM, and 2) evaluate patient and intraprocedural variables associated with post-POEM GER. Patients and methods All patients who underwent POEM and subsequent objective testing for GER (pH study with or without upper gastrointestinal [GI] endoscopy) at seven tertiary academic centers (one Asian, two US, four European) were included. Patients were divided into two groups: 1) DeMeester score ≥?14.72 (cases) and 2) DeMeester score of <?14.72 (controls). Asymptomatic GER was defined as a patient with a DeMeester score ≥?14.72 who was not consuming proton pump inhibitor (PPI). Results A total of 282 patients (female 48.2?%, Caucasian 84.8?%; mean body mass index 24.1?kg/m2) were included. Clinical success was achieved in 94.3?% of patients. GER evaluation was completed after a median follow-up of 12 months (interquartile range 10?–?24 months). A DeMeester score of?≥?14.72 was seen in 57.8?% of patients. Multivariable analysis revealed female sex to be the only independent association (odds ratio 1.69, 95?% confidence interval 1.04?–?2.74) with post-POEM GER. No intraprocedural variables were associated with GER. Upper GI endoscopy was available in 233 patients, 54 (23.2?%) of whom were noted to have reflux esophagitis (majority Los Angeles Grade A or B). GER was asymptomatic in 60.1?%. Conclusion Post-POEM GER was seen in the majority of patients. No intraprocedural variables were identified to allow for potential alteration in procedural technique.

Original languageEnglish (US)
JournalEndoscopy
DOIs
StateAccepted/In press - Feb 9 2017

Fingerprint

Gastroesophageal Reflux
Multicenter Studies
Peptic Esophagitis
Gastrointestinal Endoscopy
Los Angeles
Proton Pump Inhibitors
Body Mass Index
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Gastroesophageal reflux after peroral endoscopic myotomy : a multicenter case–control study. / Kumbhari, Vivek; Familiari, Pietro; Bjerregaard, Niels Christian; Pioche, Mathieu; Jones, Edward; Ko, Weon Jin; Hayee, Bu; Cali, Anna; Ngamruengphong, Saowanee; Mion, Francois; Hernaez, Ruben; Roman, Sabine; Tieu, Alan H.; El Zein, Mohamad; Ajayi, Tokunbo; Haji, Amyn; Cho, Joo Young; Hazey, Jeffrey; Perry, Kyle A.; Ponchon, Thierry; Kunda, Rastislav; Costamagna, Guido; Khashab, Mouen.

In: Endoscopy, 09.02.2017.

Research output: Contribution to journalArticle

Kumbhari, V, Familiari, P, Bjerregaard, NC, Pioche, M, Jones, E, Ko, WJ, Hayee, B, Cali, A, Ngamruengphong, S, Mion, F, Hernaez, R, Roman, S, Tieu, AH, El Zein, M, Ajayi, T, Haji, A, Cho, JY, Hazey, J, Perry, KA, Ponchon, T, Kunda, R, Costamagna, G & Khashab, M 2017, 'Gastroesophageal reflux after peroral endoscopic myotomy: a multicenter case–control study', Endoscopy. https://doi.org/10.1055/s-0043-105485
Kumbhari, Vivek ; Familiari, Pietro ; Bjerregaard, Niels Christian ; Pioche, Mathieu ; Jones, Edward ; Ko, Weon Jin ; Hayee, Bu ; Cali, Anna ; Ngamruengphong, Saowanee ; Mion, Francois ; Hernaez, Ruben ; Roman, Sabine ; Tieu, Alan H. ; El Zein, Mohamad ; Ajayi, Tokunbo ; Haji, Amyn ; Cho, Joo Young ; Hazey, Jeffrey ; Perry, Kyle A. ; Ponchon, Thierry ; Kunda, Rastislav ; Costamagna, Guido ; Khashab, Mouen. / Gastroesophageal reflux after peroral endoscopic myotomy : a multicenter case–control study. In: Endoscopy. 2017.
@article{603a5669b30b42f59c31edf1474893b7,
title = "Gastroesophageal reflux after peroral endoscopic myotomy: a multicenter case–control study",
abstract = "Background and study aims The variables associated with gastroesophageal reflux (GER) after peroral endoscopic myotomy (POEM) are largely unknown. This study aimed to: 1) identify the prevalence of reflux esophagitis and asymptomatic GER in patients who underwent POEM, and 2) evaluate patient and intraprocedural variables associated with post-POEM GER. Patients and methods All patients who underwent POEM and subsequent objective testing for GER (pH study with or without upper gastrointestinal [GI] endoscopy) at seven tertiary academic centers (one Asian, two US, four European) were included. Patients were divided into two groups: 1) DeMeester score ≥?14.72 (cases) and 2) DeMeester score of <?14.72 (controls). Asymptomatic GER was defined as a patient with a DeMeester score ≥?14.72 who was not consuming proton pump inhibitor (PPI). Results A total of 282 patients (female 48.2?{\%}, Caucasian 84.8?{\%}; mean body mass index 24.1?kg/m2) were included. Clinical success was achieved in 94.3?{\%} of patients. GER evaluation was completed after a median follow-up of 12 months (interquartile range 10?–?24 months). A DeMeester score of?≥?14.72 was seen in 57.8?{\%} of patients. Multivariable analysis revealed female sex to be the only independent association (odds ratio 1.69, 95?{\%} confidence interval 1.04?–?2.74) with post-POEM GER. No intraprocedural variables were associated with GER. Upper GI endoscopy was available in 233 patients, 54 (23.2?{\%}) of whom were noted to have reflux esophagitis (majority Los Angeles Grade A or B). GER was asymptomatic in 60.1?{\%}. Conclusion Post-POEM GER was seen in the majority of patients. No intraprocedural variables were identified to allow for potential alteration in procedural technique.",
author = "Vivek Kumbhari and Pietro Familiari and Bjerregaard, {Niels Christian} and Mathieu Pioche and Edward Jones and Ko, {Weon Jin} and Bu Hayee and Anna Cali and Saowanee Ngamruengphong and Francois Mion and Ruben Hernaez and Sabine Roman and Tieu, {Alan H.} and {El Zein}, Mohamad and Tokunbo Ajayi and Amyn Haji and Cho, {Joo Young} and Jeffrey Hazey and Perry, {Kyle A.} and Thierry Ponchon and Rastislav Kunda and Guido Costamagna and Mouen Khashab",
year = "2017",
month = "2",
day = "9",
doi = "10.1055/s-0043-105485",
language = "English (US)",
journal = "Endoscopy",
issn = "0013-726X",
publisher = "Georg Thieme Verlag",

}

TY - JOUR

T1 - Gastroesophageal reflux after peroral endoscopic myotomy

T2 - a multicenter case–control study

AU - Kumbhari, Vivek

AU - Familiari, Pietro

AU - Bjerregaard, Niels Christian

AU - Pioche, Mathieu

AU - Jones, Edward

AU - Ko, Weon Jin

AU - Hayee, Bu

AU - Cali, Anna

AU - Ngamruengphong, Saowanee

AU - Mion, Francois

AU - Hernaez, Ruben

AU - Roman, Sabine

AU - Tieu, Alan H.

AU - El Zein, Mohamad

AU - Ajayi, Tokunbo

AU - Haji, Amyn

AU - Cho, Joo Young

AU - Hazey, Jeffrey

AU - Perry, Kyle A.

AU - Ponchon, Thierry

AU - Kunda, Rastislav

AU - Costamagna, Guido

AU - Khashab, Mouen

PY - 2017/2/9

Y1 - 2017/2/9

N2 - Background and study aims The variables associated with gastroesophageal reflux (GER) after peroral endoscopic myotomy (POEM) are largely unknown. This study aimed to: 1) identify the prevalence of reflux esophagitis and asymptomatic GER in patients who underwent POEM, and 2) evaluate patient and intraprocedural variables associated with post-POEM GER. Patients and methods All patients who underwent POEM and subsequent objective testing for GER (pH study with or without upper gastrointestinal [GI] endoscopy) at seven tertiary academic centers (one Asian, two US, four European) were included. Patients were divided into two groups: 1) DeMeester score ≥?14.72 (cases) and 2) DeMeester score of <?14.72 (controls). Asymptomatic GER was defined as a patient with a DeMeester score ≥?14.72 who was not consuming proton pump inhibitor (PPI). Results A total of 282 patients (female 48.2?%, Caucasian 84.8?%; mean body mass index 24.1?kg/m2) were included. Clinical success was achieved in 94.3?% of patients. GER evaluation was completed after a median follow-up of 12 months (interquartile range 10?–?24 months). A DeMeester score of?≥?14.72 was seen in 57.8?% of patients. Multivariable analysis revealed female sex to be the only independent association (odds ratio 1.69, 95?% confidence interval 1.04?–?2.74) with post-POEM GER. No intraprocedural variables were associated with GER. Upper GI endoscopy was available in 233 patients, 54 (23.2?%) of whom were noted to have reflux esophagitis (majority Los Angeles Grade A or B). GER was asymptomatic in 60.1?%. Conclusion Post-POEM GER was seen in the majority of patients. No intraprocedural variables were identified to allow for potential alteration in procedural technique.

AB - Background and study aims The variables associated with gastroesophageal reflux (GER) after peroral endoscopic myotomy (POEM) are largely unknown. This study aimed to: 1) identify the prevalence of reflux esophagitis and asymptomatic GER in patients who underwent POEM, and 2) evaluate patient and intraprocedural variables associated with post-POEM GER. Patients and methods All patients who underwent POEM and subsequent objective testing for GER (pH study with or without upper gastrointestinal [GI] endoscopy) at seven tertiary academic centers (one Asian, two US, four European) were included. Patients were divided into two groups: 1) DeMeester score ≥?14.72 (cases) and 2) DeMeester score of <?14.72 (controls). Asymptomatic GER was defined as a patient with a DeMeester score ≥?14.72 who was not consuming proton pump inhibitor (PPI). Results A total of 282 patients (female 48.2?%, Caucasian 84.8?%; mean body mass index 24.1?kg/m2) were included. Clinical success was achieved in 94.3?% of patients. GER evaluation was completed after a median follow-up of 12 months (interquartile range 10?–?24 months). A DeMeester score of?≥?14.72 was seen in 57.8?% of patients. Multivariable analysis revealed female sex to be the only independent association (odds ratio 1.69, 95?% confidence interval 1.04?–?2.74) with post-POEM GER. No intraprocedural variables were associated with GER. Upper GI endoscopy was available in 233 patients, 54 (23.2?%) of whom were noted to have reflux esophagitis (majority Los Angeles Grade A or B). GER was asymptomatic in 60.1?%. Conclusion Post-POEM GER was seen in the majority of patients. No intraprocedural variables were identified to allow for potential alteration in procedural technique.

UR - http://www.scopus.com/inward/record.url?scp=85019021397&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019021397&partnerID=8YFLogxK

U2 - 10.1055/s-0043-105485

DO - 10.1055/s-0043-105485

M3 - Article

C2 - 28472834

AN - SCOPUS:85019021397

JO - Endoscopy

JF - Endoscopy

SN - 0013-726X

ER -