Heller myotomy is the optimal index procedure for esophageal achalasia in adolescents and young adults.
1/5 보강
PICO 자동 추출 (휴리스틱, conf 3/4)
유사 논문P · Population 대상 환자/모집단
환자: this disease studied to date
I · Intervention 중재 / 시술
HM, ED or botox
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
[CONCLUSIONS] HM has a similar risk of complications but a significantly lower risk of re-intervention when compared to ED and botox. Based on our findings, we recommend HM as the optimal index procedure for AYAs with achalasia.
[BACKGROUND] There is limited and conflicting data on the optimal intervention for the treatment of achalasia in adolescents and young adults (AYA), Heller myotomy (HM), esophageal dilation (ED) or bo
- p-value p < 0.001
- p-value p < 0.01
- 추적기간 5.2 years
APA
Hung YC, Westfal ML, et al. (2019). Heller myotomy is the optimal index procedure for esophageal achalasia in adolescents and young adults.. Surgical endoscopy, 33(10), 3355-3360. https://doi.org/10.1007/s00464-018-06625-6
MLA
Hung YC, et al.. "Heller myotomy is the optimal index procedure for esophageal achalasia in adolescents and young adults.." Surgical endoscopy, vol. 33, no. 10, 2019, pp. 3355-3360.
PMID
30552502 ↗
Abstract 한글 요약
[BACKGROUND] There is limited and conflicting data on the optimal intervention for the treatment of achalasia in adolescents and young adults (AYA), Heller myotomy (HM), esophageal dilation (ED) or botulinum toxin injection (botox). The goal of this study is to determine the most appropriate index intervention for achalasia in the AYA population.
[METHODS] We completed a longitudinal, population-based analysis of the California (2005-2010) and New York (1999-2014) statewide databases. We included patients 9-25 years old with achalasia who underwent HM, ED or botox. Comparisons were made based on the patients' index procedure. Rates of 30-day complications, long-term complications, and re-intervention up to 14 years were calculated. Cox regression was performed to determine the risk of re-intervention, adjusting for patient demographics.
[RESULTS] A total of 442 AYAs were analyzed, representing the largest cohort of young patients with this disease studied to date. Median follow-up was 5.2 years (IQR 1.8-8.0). The overall rate of re-intervention was 29.3%. Rates of re-intervention for ED and botox were equivalent and higher than HM (65.0% for ED, 47.4% for botox and 16.4% for HM, p < 0.001). Ultimately, 46.9% of ED and botox patients underwent HM. The overall short-term complication rate was 4.3% and long-term, 1.9%. There was no difference in the short-term and long-term complication rates between intervention groups (p > 0.05). On adjusted analysis, ED and botox were associated with increased risks of re-intervention when compared to HM (HR 5.9, HR 4.8, respectively, p < 0.01). Black patients were found to have a risk of re-intervention twice that of white patients (HR 2.0, p = 0.05).
[CONCLUSIONS] HM has a similar risk of complications but a significantly lower risk of re-intervention when compared to ED and botox. Based on our findings, we recommend HM as the optimal index procedure for AYAs with achalasia.
[METHODS] We completed a longitudinal, population-based analysis of the California (2005-2010) and New York (1999-2014) statewide databases. We included patients 9-25 years old with achalasia who underwent HM, ED or botox. Comparisons were made based on the patients' index procedure. Rates of 30-day complications, long-term complications, and re-intervention up to 14 years were calculated. Cox regression was performed to determine the risk of re-intervention, adjusting for patient demographics.
[RESULTS] A total of 442 AYAs were analyzed, representing the largest cohort of young patients with this disease studied to date. Median follow-up was 5.2 years (IQR 1.8-8.0). The overall rate of re-intervention was 29.3%. Rates of re-intervention for ED and botox were equivalent and higher than HM (65.0% for ED, 47.4% for botox and 16.4% for HM, p < 0.001). Ultimately, 46.9% of ED and botox patients underwent HM. The overall short-term complication rate was 4.3% and long-term, 1.9%. There was no difference in the short-term and long-term complication rates between intervention groups (p > 0.05). On adjusted analysis, ED and botox were associated with increased risks of re-intervention when compared to HM (HR 5.9, HR 4.8, respectively, p < 0.01). Black patients were found to have a risk of re-intervention twice that of white patients (HR 2.0, p = 0.05).
[CONCLUSIONS] HM has a similar risk of complications but a significantly lower risk of re-intervention when compared to ED and botox. Based on our findings, we recommend HM as the optimal index procedure for AYAs with achalasia.
추출된 의학 개체 (NER)
전체 NER 표 보기
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | botox
|
보툴리눔독소 주사 | dict | 7 | |
| 시술 | botulinum toxin
|
보툴리눔독소 주사 | dict | 1 |
🏷️ 키워드 / MeSH 📖 같은 키워드 OA만
- Adolescent
- Adult
- Black or African American
- Botulinum Toxins
- California
- Child
- Dilatation
- Esophageal Achalasia
- Female
- Heller Myotomy
- Humans
- Longitudinal Studies
- Male
- Neurotoxins
- New York
- Reoperation
- Retrospective Studies
- White People
- Young Adult
- Achalasia
- Adolescents and young adults
- Complication rates
- Long-term re-intervention rates
함께 등장하는 도메인
이 논문이 속한 카테고리와 같은 논문에서 자주 함께 다뤄지는 카테고리들
같은 제1저자의 인용 많은 논문 (1)
🏷️ 같은 키워드 · 무료전문 — 이 논문 MeSH/keyword 기반
- Clinical and Liquid Biomarkers of 20-Year Prostate Cancer Risk in Men Aged 45 to 70 Years.
- Clinical Presentation and Outcomes of Patients Undergoing Surgery for Thyroid Cancer.
- Association of patient health education with the postoperative health related quality of life in low- intermediate recurrence risk differentiated thyroid cancer patients.
- Early local immune activation following intra-operative radiotherapy in human breast tissue.
- Impact of Comorbidities on Clinical Outcomes and Quality of Life of Patients With Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative (HR+/HER2-) Advanced Breast Cancer Treated With Palbociclib in the POLARIS Study.
- Whole-body MRI for staging and follow-up of primary musculoskeletal tumours: a systematic review.
📖 비슷한 OA 논문 — 같은 카테고리, 무료 전문 가능
- Mechanisms of Botulinum Toxin Type A Action on Pain.
- Effect of Botulinum Toxin Injection on EMG Activity and Bite Force in Masticatory Muscle Disorder: A Randomized Clinical Trial.
- Botulinum Toxin: An Update on Pharmacology and Newer Products in Development.
- Immunogenicity of botulinum toxin.
- Botulinum Toxin in the Treatment of Headache.