Quality of Life Assessment after Peroral Endoscopic Myotomy

Y Vigneswaran, MD, R Tanaka, M Gitelis, J Carbray, BS, M Ujiki, MD, FACS. NorthShore University Health System.

Purpose: To determine if quality of life after POEM is comparable to laparoscopic Heller myotomy.

Methods: All patients who presented to our institution for surgical treatment of achalasia between 2009 and 2013 were asked to complete quality of life (SF-36), dysphagia, reflux severity index and GERD questionnaires in clinic preoperatively and postoperatively at approximately six weeks, six months, one year and two years. Additionally all patients identified with an achalasia diagnosis in our electronic medical record were given a more brief mail-in questionnaire including dysphagia, reflux severity index and GERD questions.

Results: At average follow up of 4.4 months, POEM patients (n=33) had significant improvement in dysphagia scores (p=0.029), reflux severity scores (p= 0.031) and GERD scores (p=0.0006). SF-36 questionnaires specifically demonstrated a significant improvement in both pain scores (p=0.047) and social functioning scores (p=0.027).

When compared to those patients who underwent treatment with Heller myotomy at follow up of 86.9 months, POEM had significantly higher post-operative dysphagia (p=0.007), reflux severity index (p=0.003) and GERD scores (p=0.04). When compared to endoscopic procedures at follow up of 140.8 months, POEM had significantly better scores in reflux severity index (p=0.03), but comparable dysphagia and GERD scores.

Conclusion: There is significant improvement in several measures of quality of life after POEM, which in some cases may be superior to that seen after laparoscopic Heller myotomy.


View Poster

« Return to SAGES 2014 abstract archive