Clinical and physiological outcomes of peroral endoscopic myotomy in Thailand, with a comparative review of Southeast Asian cohorts

Information from the abstract

Peroral endoscopic myotomy (POEM) is an established therapy for achalasia, but data from Southeast Asia remain limited. We evaluated the clinical and physiological outcomes of POEM in Thai patients and compared them with regional cohorts from Singapore and Malaysia. We analyzed a pooled Thai cohort of 127 patients who underwent POEM between 2014 and 2024 and compared outcomes with published cohorts from Singapore (n = 58) and Malaysia (n = 65). Clinical success was defined as an Eckardt score ≤ 3 during the follow-up period. A total of 250 patients were included. Clinical success was achieved in 89.9%, 93.0%, and 93.4% of patients in Thailand, Singapore, and Malaysia, respectively. In the Thai cohort, significant improvements were observed in Eckardt scores, integrated relaxation pressure, and timed barium esophagogram parameters (p < 0.05). Post-POEM reflux occurred in 23.1% of Thai, 43.1% of Singaporean, and 37.0% of Malaysian patients. POEM is a safe and effective treatment for achalasia in Thailand, with clinical outcomes comparable to regional benchmarks. Differences in reflux rates suggest potential heterogeneity in practice and follow-up, highlighting the need for standardized regional protocols.

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Related topics: Gastroesophageal reflux and treatments · Gastrointestinal motility and disorders · Bariatric Surgery and Outcomes