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Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video)
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Kelly E. Hathorn, Walter W. Chan, Hiroyuki Aihara, Christopher C. Thompson
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Clin Endosc 2020;53(4):443-451. Published online May 22, 2020
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DOI: https://doi.org/10.5946/ce.2019.214
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 Abstract
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- Background
/Aims: Peroral endoscopic myotomy (POEM) has recently come to the forefront in the management of achalasia. We aimed to analyze the efficacy and safety of the use of electrocautery enhanced scissors (EES) for POEM.
Methods
This retrospective cohort study prospectively collected the data of all adult patients (aged ≥18 years) with normal foregut anatomy who underwent POEM using EES. The patients’ baseline characteristics and procedure details (time, tunnel length, myotomy length, depth, and location) were recorded. The primary outcome was clinical success (3-month post-procedure Eckardt score of ≤3). The secondary outcomes were technical success and adverse events. A paired Student’s t-test was performed.
Results
Fifteen patients were included in this study. The technical success rate of myotomy using EES was 100%. Fellows participated in the myotomy in all cases. The clinical success rate was 93.3% (14/15). The mean pre-Eckardt score was 5.4±2.5, while the mean post-Eckardt score was 1.3±1.3, which indicated a significant improvement (p≤0.0001). The most common treatment-related adverse events were post-procedure pain (4, 26.7%) and symptomatic reflux disease (4, 26.7%).
Conclusions
In the largest series to date on the use of EES in POEM, we demonstrated that this technique has both technical and clinical efficacy as well as an excellent safety profile.
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Citations
Citations to this article as recorded by  - Peroral endoscopic myotomy using an endoscopic dissector: another novel device in our toolbox
Shruti Mony, Apurva Shrigiriwar, Andrew Canakis, Mouen A. Khashab
VideoGIE.2023; 8(1): 5. CrossRef - Peroral endoscopic myotomy (POEM) is more cost-effective than laparoscopic Heller myotomy in the short term for achalasia: economic evaluation from a randomized controlled trial
Tatiana Morgado Conte, Luciana Bertocco de Paiva Haddad, Igor Braga Ribeiro, Eduardo Turiani Hourneaux de Moura, Luiz Augusto Carneiro DʼAlbuquerque, Eduardo Guimarães Hourneaux de Moura
Endoscopy International Open.2020; 08(11): E1673. CrossRef
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A Prospective Blinded Study of Endoscopic Ultrasound Elastography in Liver Disease: Towards a Virtual Biopsy
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Allison R. Schulman, Ming V. Lin, Anna Rutherford, Walter W. Chan, Marvin Ryou
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Clin Endosc 2018;51(2):181-185. Published online March 23, 2018
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DOI: https://doi.org/10.5946/ce.2017.095
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Abstract
PDFPubReaderePub
- Background
/Aims: Liver biopsy has traditionally been used for determining the degree of fibrosis, however there are several limitations. Endoscopic ultrasound (EUS) real-time elastography (RTE) is a novel technology that uses image enhancement to display differences in tissue compressibility. We sought to assess whether liver fibrosis index (LFI) can distinguish normal, fatty, and cirrhotic liver tissue.
Methods
A total of 50 patients undergoing EUS were prospectively enrolled. RTE of the liver was performed to synthesize the LFI in each patient. Univariate and multivariable analyses were performed. Chi-square and t-tests were performed for categorical and continuous variables, respectively. A p-value of <0.05 was considered significant.
Results
Abdominal imaging prior to endoscopic evaluation suggested normal tissue, fatty liver, and cirrhosis in 26, 16, and 8 patients, respectively. Patients with cirrhosis had significantly increased mean LFI compared to the fatty liver (3.2 vs. 1.7, p<0.001) and normal (3.2 vs. 0.8, p<0.001) groups. The fatty liver group showed significantly increased LFI compared to the normal group (3.8 vs. 1.4, p<0.001). Multivariable regression analysis suggested that LFI was an independent predictor of group features (p<0.001).
Conclusions
LFI computed from RTE images significantly correlates with abdominal imaging and can distinguish normal, fatty, and cirrhotic-appearing livers; therefore, LFI may play an important role in patients with chronic liver disease.
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Citations
Citations to this article as recorded by - Endoscopic Ultrasound-based Shear Wave Elastography for Detection of Advanced Liver Disease
Jad AbiMansour, Jerry Yung-Lun Chin, Jyotroop Kaur, Eric J. Vargas, Barham K. Abu Dayyeh, Ryan Law, Vishal Garimella, Michael J. Levy, Andrew C. Storm, Ross Dierkhising, Alina Allen, Sudhakar Venkatesh, Vinay Chandrasekhara
Journal of Clinical Gastroenterology.2025; 59(3): 256. CrossRef - The Role of Endoscopic Ultrasound in Assessing Portal Hypertension: A State‐of‐the‐Art Literature Review and Evolving Perspectives
Fabrizio Termite, Federica Borrelli de Andreis, Antonio Liguori, Antonio Gasbarrini, Fabia Attili, Cristiano Spada, Luca Miele
Liver International.2025;[Epub] CrossRef - EUS-guided shear wave elastography for fibrosis screening in patients with obesity and metabolic dysfunction–associated steatotic liver disease: a pilot study (with video)
Thomas J. Wang, Pichamol Jirapinyo, Raj Shah, Kimberly Schuster, David J. Papke, Christopher C. Thompson, Laura Doyon, David B. Lautz, Marvin Ryou
Gastrointestinal Endoscopy.2025; 101(2): 456. CrossRef - Interventional Endoscopic Ultrasonography: Advances in Application
Haidar Khan, Sharon Slomovich, Neal C. Shah, Frank Gress
Journal of Clinical Medicine.2025; 14(10): 3286. CrossRef - The Benign Liver EUS Optimal Core Study (BLOCs)
Neil R. Sharma, Harishankar Gopakumar, Harshit Khara, Abhilash Perisetti, Saurabh Gupta, Mariajose Rojas DeLeon, Marzena Muller, Christina Zelt, Mindy Flanagan, Ashley Rumple, Amitpal Johal, Bradley Confer, Jiahong Li, Meir Mizrahi, Ann Chen, Kefu Li, Moh
Journal of Clinical Gastroenterology.2025;[Epub] CrossRef - Endohepatology: The endoscopic armamentarium in the hand of the hepatologist
Ahmed Alwassief, Said Al-Busafi, Qasim L. Abbas, Khalid Al Shamusi, Sarto C. Paquin, Anand V. Sahai
Saudi Journal of Gastroenterology.2024; 30(1): 4. CrossRef - Preliminary Study on the Evaluation of Liver Fibrosis Using Endoscopic Ultrasound Elastography and Transabdominal Ultrasound Transient Elastography Combined with Strain Ratio
Dun-Wei Yao, Hai-Xing Jiang, Shan-Yu Qin
Hepatitis Monthly.2024;[Epub] CrossRef - Endoscopic ultrasound-guided tissue acquisition for the diagnosis of focal liver lesion
Alina Tantău, Cosmina Sutac, Anamaria Pop, Marcel Tantău
World Journal of Radiology.2024; 16(4): 72. CrossRef - Comparative accuracy of endosonographic shear wave elastography and transcutaneous liver stiffness measurement: a pilot study
Divyanshoo R. Kohli, Daniel Mettman, Nevene Andraws, Erin Haer, Jaime Porter, Ozlem Ulusurac, Steven Ullery, Madhav Desai, Mohammad S. Siddiqui, Prateek Sharma
Gastrointestinal Endoscopy.2023; 97(1): 35. CrossRef - The Role of Endoscopic Ultrasound in Hepatology
Saleh A. Alqahtani, Floriane Ausloos, Ji Seok Park, Sunguk Jang
Gut and Liver.2023; 17(2): 204. CrossRef - Distinct ways to perform a liver biopsy: The core technique setups and updated understanding of these modalities
Chao Sun, Xingliang Zhao, Lei Shi, Xiaofei Fan, Xiaolong Qi
Endoscopic Ultrasound.2023; 12(6): 437. CrossRef - Future Directions in EndoHepatology
Ahmad Najdat Bazarbashi, Lolwa Al-Obaid, Marvin Ryou
Techniques and Innovations in Gastrointestinal Endoscopy.2022; 24(1): 98. CrossRef - The role of endoscopic ultrasound for portal hypertension in liver cirrhosis
Cosmas Rinaldi Adithya Lesmana, Maria Satya Paramitha, Rino A. Gani, Laurentius A. Lesmana
Journal of Medical Ultrasonics.2022; 49(3): 359. CrossRef - Endoscopic Ultrasound-Guided Liver Biopsy: Where Do We Stand?
Enad Dawod, Jose Nieto, Sammy Saab
American Journal of Gastroenterology.2022; 117(2): 205. CrossRef - Utilidad del índice de fibrosis hepática (IFH) medido durante la ultrasonografía endoscópica en la evaluación del parénquima pancreático
Martín Alonso Gómez Zuleta, Oscar Fernando Ruíz Morales, Eddy Johanna Buitrago Laguado
Revista colombiana de Gastroenterología.2022; 37(1): 10. CrossRef - Endohepatology – current status
Jerome C. Edelson, Natalie E. Mitchell, Don C. Rockey
Current Opinion in Gastroenterology.2022; 38(3): 216. CrossRef - The expanding role of endoscopic ultrasound elastography
Jahnvi Dhar, Jayanta Samanta
Clinical Journal of Gastroenterology.2022; 15(5): 841. CrossRef - Diagnostic and interventional EUS in hepatology: An updated review
Vaneet Jearth, Sridhar Sundaram, Surinder Singh Rana
Endoscopic Ultrasound.2022; 11(5): 355. CrossRef - Enhanced EUS imaging (with videos)
Kumar Krishnan, Manoop S. Bhutani, Harry R. Aslanian, Joshua Melson, Udayakumar Navaneethan, Rahul Pannala, Mansour A. Parsi, Allison R. Schulman, Amrita Sethi, Shelby Sullivan, Guru Trikudanathan, Arvind J. Trindade, Rabindra R. Watson, John T. Maple, Da
Gastrointestinal Endoscopy.2021; 93(2): 323. CrossRef - Real-Time Tissue Elastography to Evaluate Hepatic Hypoxic-Ischemic Injury Caused by Brain Death
Guoying Zhang, Ying Tang, Huimin Yu, Weina Kong, Yun Chen, Yang Liu, Jingwen Zhao
Ultrasound Quarterly.2021; 37(2): 138. CrossRef - Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?
Tajana Pavic, Ivana Mikolasevic, Dominik Kralj, Nina Blazevic, Anita Skrtic, Ivan Budimir, Ivan Lerotic, Davor Hrabar
Diagnostics.2021; 11(11): 2021. CrossRef - Role of endoscopic ultrasound in the field of hepatology: Recent advances and future trends
Jahnvi Dhar, Jayanta Samanta
World Journal of Hepatology.2021; 13(11): 1459. CrossRef - Endoscopic ultrasound in chronic liver disease
Brian M Fung, Alexander P Abadir, Armen Eskandari, Michael J Levy, James H Tabibian
World Journal of Hepatology.2020; 12(6): 262. CrossRef - A State-of-the-Art Review on the Evolving Utility of Endoscopic Ultrasound in Liver Diseases Diagnosis
Wisam Sbeit, Anas Kadah, Mahmud Mahamid, Rinaldo Pellicano, Amir Mari, Tawfik Khoury
Diagnostics.2020; 10(8): 512. CrossRef - Comparison of EUS-guided versus percutaneous and transjugular approaches for the performance of liver biopsies
Asim Shuja, Ahmad Alkhasawneh, Andre Fialho, Andrea Fialho, Amal Shukri, Ciel Harris, Carmen Smotherman, Miguel Malespin, Silvio W. de Melo
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