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Effect of peroral endoscopic myotomy in geriatric patients: a propensity score matching study.
- Source :
- Surgical Endoscopy & Other Interventional Techniques; Jul2020, Vol. 34 Issue 7, p2911-2917, 7p, 3 Charts, 2 Graphs
- Publication Year :
- 2020
-
Abstract
- <bold>Background: </bold>Peroral endoscopic myotomy (POEM) is a safe and effective approach for achalasia. However, the safety, feasibility, perioperative and long-term efficacy in treating geriatric patients has not been well evaluated.<bold>Methods: </bold>Data of 2367 patients diagnosed with achalasia and treated with POEM in the Endoscopy Center, Zhongshan Hospital, Fudan University from August 2010 to December 2017 were retrospectively reviewed. Last follow-up was in December 2018. Propensity score matching based on baseline characteristics was used to adjust for confounding. With a caliper of 0.01 in propensity scoring, 139 patients aged ≥ 65 years were matched at a 1:2 ratio with 275 patients aged < 65 years. Perioperative complications and long-term outcomes were compared between the two groups.<bold>Results: </bold>After propensity score matching, the two groups had similar baseline clinical characteristics and distribution of propensity scores. The mean age was 70.22 years in geriatric patients and 42.02 in younger patients. Technical failure occurred in one geriatric and one non-geriatric patients (p = 0.485). The procedural time in geriatric patients was similar to younger patients [50 (interquartile range (IQR) 36-76) vs. 50 (IQR 36-70) min, p = 0.398]. There were also no significant differences in major perioperative adverse events (2.88% vs. 2.18%, p = 0.663) and hospitalization length (median 3 vs. 3 days, p = 0.488). During a median follow-up period of 41 months (IQR 26-60), mean decrease in Eckardt score and pressure of the LES were 6.63 and 11.9 mmHg in geriatric patients, which were similar to the change in non-geriatric patients (6.49 and 11.6 mmHg, p = 0.652 and 0.872, respectively). Clinical reflux occurred in 23.53% geriatric patients and 21.59% non-geriatric patients (p = 0.724). 5-year success rate of 92.94% was achieved in geriatric patients and 92.61% in younger patients (log-rank p = 0.737).<bold>Conclusions: </bold>POEM is a safe and reliable treatment in geriatric achalasia patients with confirmed short-term and long-term efficacy compared with those in non-geriatric patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- PROPENSITY score matching
SURGICAL complications
LENGTH of stay in hospitals
RESEARCH
RESEARCH methodology
RETROSPECTIVE studies
MEDICAL cooperation
EVALUATION research
TREATMENT effectiveness
GASTROESOPHAGEAL reflux
COMPARATIVE studies
DIGESTIVE organ surgery
RESEARCH funding
ENDOSCOPY
ESOPHAGEAL achalasia
PROBABILITY theory
Subjects
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 34
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 143572527
- Full Text :
- https://doi.org/10.1007/s00464-019-07070-9