Achalasia Clinical Trial
Official title:
Endoscopic Peroral Myotomy for Treatment of Achalasia: Multicenter Study
This study intends to investigate the feasibility, safety and efficacy of peroral endoscopic myotomy for the treatment of achalasia in a multi center setting.
This study intends to investigate the feasibility, safety and efficacy of peroral endoscopic
myotomy for the treatment of achalasia in a multi center s
70 patients will be enrolled to evaluate feasibility, safety and efficacy of peroral
endoscopic myotomy. Main outcome measurement is the Eckardt symptom score at 3 month after
peroral endoscopic myotomy.
Primary outcome:
-Eckhard symptom score 3 month after therapy.
Secondary outcomes:
Lower esophageal sphincter pressure at 3 month after therapy. Reflux symptoms at 3 month
after therapy. For this prospective study, inclusion criteria are achalasia, as diagnosed by
established methods (contrast fluoroscopy, manometry, esophago-gastro-duodenoscopy) and age
greater than 18 years. Previous therapy, such as esophageal surgery or previous myotomy are
exclusion criterion.
A forward-viewing upper endoscope is used with a transparent distal cap attachment. Carbon
dioxide gas is necessary for insufflation during the procedures. An endoscopic knife is used
to access the submucosa, dissect the submucosal tunnel and also to divide circular muscle
bundles over a length of approximately 10cm, extending 2-3cm onto the cardia. A
electrogenerator is used with spray coagulation mode. A coagulating forceps is used for
hemostasis as needed. Closure of the mucosal entry site is performed using standard
endoscopic clips.
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