Clinical Endoscopy

Original Article

Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand: Tharathorn Suwatthanarak, Chainarong Phalanusitthepa, Chatbadin Thongchuam, Thawatchai Akaraviputh, Vitoon Chinswangwatanakul, Thikhamporn Tawantanakorn, Somchai Leelakusolvong, Monthira Maneerattanaporn, Piyaporn Apisarnthanarak, Jitladda Wasinrat; Clin Endosc 2024;57(5):610-619. Published online June 14, 2024; DOI: https://doi.org/10.5946/ce.2023.236

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Background
/Aims: Achalasia is a rare esophageal motility disease, for which peroral endoscopic myotomy (POEM) has emerged as a promising treatment option; however, recurrence remains a challenge. Timed barium esophagography (TBE) is a useful diagnostic tool and potential outcome predictor of achalasia. This study aimed to determine predictive tools for recurrence after POEM.
Methods
This retrospective study enrolled achalasia patients who underwent POEM between January 2015 and December 2021. Patients were categorized into two groups using the 1-month post-POEM Eckardt scores and TBE: the discordant group (Eckardt score improved >50%, TBE decreased <50%) and the concordant group (both Eckardt score and TBE improved >50%). Recurrence was defined as a reincrease in the Eckardt score to more than three during follow-up.
Results
Complete medical records were available in 30 patients who underwent POEM. Seventeen patients (56.7%) were classified into the discordant group, while 13 patients (43.3%) were in the concordant group. The overall recurrence rate was 11.9% at 1-year, increasing to 23.8% during the extended follow-up. The discordant group had a 6.87 fold higher recurrence rate than the concordant group (52.9% vs. 7.7%, p=0.017).
Conclusions
These results strongly suggest that combining the Eckardt score with TBE can effectively predict recurrent achalasia after POEM. Patients in the discordant group had an elevated risk.

Citations

Citations to this article as recorded by

Assessment and Management of Reflux‐Related Esophageal Stricture After Peroral Endoscopic Myotomy in Achalasia
Shao‐Bin Luo, Zu‐Qiang Liu, Li Wang, Ming‐Yan Cai, Quan‐Lin Li, Ping‐Hong Zhou, Wei‐Feng Chen
Journal of Gastroenterology and Hepatology.2026; 41(1): 248. CrossRef
Pressure‐flow analysis following peroral endoscopic myotomy in pediatric achalasia: Novel insights into esophageal emptying
Renato Tambucci, Giulia Chiarazzo, Nathalie Rommel, Chiara Imondi, Tamara Caldaro, Paola De Angelis, Valerio Balassone
Journal of Pediatric Gastroenterology and Nutrition.2026;[Epub] CrossRef
Never judge a book by its cover: the role of timed barium esophagography in patients with complete symptom relief after peroral endoscopic myotomy
Tae Hee Lee
Clinical Endoscopy.2024; 57(5): 604. CrossRef

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Case Report

Successful Closure of a Benign Refractory Tracheoesophageal Fistula Using an Over-the-Scope Clip after Failed Esophageal Stent Placement and Surgical Management: Nonthalee Pausawasdi, Chotirot Angkurawaranon, Tanyaporn Chantarojanasiri, Arunchai Chang, Wanchai Wongkornrat, Somchai Leelakusolvong, Asada Methasate; Clin Endosc 2020;53(3):361-365. Published online October 28, 2019; DOI: https://doi.org/10.5946/ce.2019.106

Abstract PDF Supplementary Material PubReader ePub

Tracheoesophageal fistulas (TEFs) have traditionally been managed surgically, but the endoscopic approach is widely performed as a less invasive alternative. Different closure techniques have been proposed with inconsistent results. An over-the-scope clip (OTSC) appears to be a reasonable option, but long-term results have not been well defined. We report the long-term outcomes of a complex case of successful closure of a benign refractory TEF using an OTSC after failed surgical management and esophageal stent placement.

Citations

Citations to this article as recorded by

The Use of Over-the-scope Clips to Close Perforations and Fistulas
Ashwariya Ohri, Mayank Goyal, Preeyati Chopra, Navtej S. Buttar
Gastrointestinal Endoscopy Clinics of North America.2026; 36(2): 321. CrossRef
Endoscopic closure of tracheoesophageal fistula using a novel over-the-scope clip
Qi Gong, Aihong Yin, Zhi Wei
Asian Journal of Surgery.2025; 48(5): 3450. CrossRef
Successful closure using Over-the-scope-Clip of an H-type Congenital Esophagobronchial Fistula presenting in an Adult with Recurrent Pneumonia
L. Laurel, M. Garcia, J. Co, G. Mendoza
Endoscopy.2024; 56(S 02): S297. CrossRef
Successful Closure of a Tracheoesophageal Fistula Using an Over-The-Scope Clip
Osman Ali, Gurbani Singh, Sindhura Kolachana, Mohammed a Khan, Varun Kesar
Cureus.2023;[Epub] CrossRef
Over-the-Scope Clip Closure of Persistent Gastrocutaneous Fistula After Percutaneous Endoscopic Gastrostomy Tube Removal: A Report of Two Cases
Shigenori Masaki, Keishi Yamada
Cureus.2021;[Epub] CrossRef
Over-the-Scope Clip-Associated Endoscopic Muscular Dissection for Seven Cases of Small Gastric Submucosal Tumor: A Video-Based Case Series
Xin Li, Rongfen Wei, Jianfu Qin, Fei Qin, Peng Peng, Mengbin Qin, Shiquan Liu, Jiean Huang, Piero Chirletti
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef

8,905 View
184 Download
4 Web of Science
6 Crossref

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