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Correlation of timed barium esophagography with Eckardt score in primary achalasia patients treated with peroral endoscopic myotomy

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Abstract

Purpose

The purpose of our study was to evaluate the role of timed barium esophagogram (TBE) in quantitative measurement of improved esophageal emptying in primary achalasia patients treated with POEM. Also, we investigated the correlation of TBE with improvement of clinical symptoms as measured by Eckardt score.

Methods

This retrospective study included 30 patients who underwent POEM due to primary achalasia. As a baseline study, all patients underwent TBE and were evaluated for clinical status by Eckardt score based on presence and frequency of dysphagia, regurgitation, substernal pain, and weight loss. Follow-up evaluation was performed within 3 months after POEM. Pre- and post-POEM TBE results were compared using a calculated value based on summation of height of the barium columns on 1-, 2- and 5-min delayed images. Also, the correlation of TBE with improvement of Eckardt score was evaluated using Pearson's correlation test.

Results

There was a significant decrease in the calculated value of height between pre- and post-POEM TBE studies (40.5 ± 15.8–17.0 ± 11.6, p < 0.01). Also, the Eckardt score decreased significantly after POEM (6.7 ± 2.0–0.8 ± 1.0, p < 0.01). Pearson’s correlation test revealed a positive correlation between improvement of TBE results and Eckardt score (correlation coefficient = 0.56, p < 0.01).

Conclusion

TBE is an objective method for quantitative measurement of improved esophageal emptying in primary achalasia patients treated with POEM and shows positive correlation with clinical symptoms evaluated by Eckardt score.

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Abbreviations

EGJ:

Esophagogastric junction

LES:

Lower esophageal sphincter

POEM:

Peroral endoscopic myotomy

SD:

Standard deviation

TBE:

Timed barium esophagogram

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Acknowledgements

This work was supported by the Soonchunhyang University Research Fund.

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Authors and Affiliations

  1. Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, 170 Jomaru-ro, Bucheon-Si, Gyeonggi-do, 14584, Republic of Korea

    Ha Eun Jo, Ji Eun Lee, Seo-Youn Choi, Min Hee Lee & Sanghyeok Lim

  2. Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon Hospital, 170 Jomaru-ro, Bucheon-Si, Gyeonggi-do, 14584, Republic of Korea

    Shin Hee Kim & Su Jin Hong

  3. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Sunyoung Lee

  4. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul, 06351, Korea

    Jeong Ah Hwang

  5. Department of Biostatistics, Clinical Trial Center, Soonchunhyang University College of Medicine, Bucheon Hospital, 170 Jomaru-ro, Bucheon-Si, Gyeonggi-do, 14584, Republic of Korea

    Ji Eun Moon

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  1. Ha Eun Jo
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Correspondence to Ji Eun Lee.

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Jo, H.E., Lee, J.E., Kim, S.H. et al. Correlation of timed barium esophagography with Eckardt score in primary achalasia patients treated with peroral endoscopic myotomy. Abdom Radiol 47, 538–546 (2022). https://doi.org/10.1007/s00261-021-03379-z

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