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Erschienen in: European Surgery 5/2019

01.03.2019 | original article

Systematic review and meta-analysis on the treatment of diffuse esophageal spasm

verfasst von: Harry Vercoe, Mubashir Mulla, MD, Wyn G. Lewis, FRCS, Antonio Foliaki, FRCS, David S. Y. Chan, FRCS

Erschienen in: European Surgery | Ausgabe 5/2019

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Summary

Background

Diffuse esophageal spasm is a rare motility disorder and although diagnosis has improved over the years, optimal treatment remains controversial. The aim of this study was to determine the success rates of alternative treatments for diffuse esophageal spasm.

Methods

MEDLINE, EMBASE, and the Cochrane Library were searched for studies which reported treatment outcomes in patients with diffuse esophageal spasm. The primary outcome measure was success rate. Secondary outcome measures were morbidity and mortality.

Results

Ten observational studies involving 101 patients (35 male, 66 female, median age 61 years) with diffuse esophageal spasm treated with nifedipine (n = 24), botulinum toxin (n = 41), and surgery (n = 46) were analyzed. At a median follow-up of 8 months, the overall success rates for nifedipine, botulinum toxin, and surgery were 42.74% (95% c. i. [42.68–42.79], p < 0.00001), 74.39% (95% c. i. [74.27–74.52], p < 0.00001), and 95.74% (95% c. i. [95.69–95.80], p < 0.00001), respectively. Morbidity after surgery was 2% and no operative deaths were reported.

Conclusion

Surgery appears to be safe and the most successful treatment. The less invasive medical and botulinum toxin therapies provide short-term symptom relief.
Literatur
1.
Zurück zum Zitat Storr M, Allescher HD, Classen M. Current concepts on pathophysiology, diagnosis and treatment of diffuse oesophageal spasm. Drugs. 2001;61(5):579–91.CrossRefPubMed Storr M, Allescher HD, Classen M. Current concepts on pathophysiology, diagnosis and treatment of diffuse oesophageal spasm. Drugs. 2001;61(5):579–91.CrossRefPubMed
4.
Zurück zum Zitat Bodger K, Trudgill NJ. Guidelines for oesophageal manometry and pH monitoring. In: BSG guidelines in gastroenterology. 2006. pp. 1–12. Bodger K, Trudgill NJ. Guidelines for oesophageal manometry and pH monitoring. In: BSG guidelines in gastroenterology. 2006. pp. 1–12.
11.
Zurück zum Zitat Eypasch EP, DeMeester TR, Klingman RR, Stein HJ. Physiologic assessment and surgical management of diffuse esophageal spasm. J Thorac Cardiovasc Surg. 1992;104(4):859–68. discussion 68–9.PubMed Eypasch EP, DeMeester TR, Klingman RR, Stein HJ. Physiologic assessment and surgical management of diffuse esophageal spasm. J Thorac Cardiovasc Surg. 1992;104(4):859–68. discussion 68–9.PubMed
12.
Zurück zum Zitat Khashab M, Messallam AA, Onimaru M, Teitelbaum EN, Ujiki MB, Gitelis ME, et al. International multicenter experience with peroral endoscopic myotomy (POEM) for the treatment of spastic esophageal disorders refractory to medical therapy. Gastrointest Endosc. 2014;1:AB167.CrossRef Khashab M, Messallam AA, Onimaru M, Teitelbaum EN, Ujiki MB, Gitelis ME, et al. International multicenter experience with peroral endoscopic myotomy (POEM) for the treatment of spastic esophageal disorders refractory to medical therapy. Gastrointest Endosc. 2014;1:AB167.CrossRef
15.
Zurück zum Zitat Storr M, Allescher HD, Rosch T, Born P, Weigert N, Classen M. Treatment of symptomatic diffuse esophageal spasm by endoscopic injection of botulinum toxin: a prospective study with long term follow-up. Gastrointest Endosc. 2001;54(6):18A.CrossRefPubMed Storr M, Allescher HD, Rosch T, Born P, Weigert N, Classen M. Treatment of symptomatic diffuse esophageal spasm by endoscopic injection of botulinum toxin: a prospective study with long term follow-up. Gastrointest Endosc. 2001;54(6):18A.CrossRefPubMed
17.
Zurück zum Zitat Blackwell JN, Holt S, Heading RC. Effect of nifedipine on oesophageal motility and gastric emptying. Digestion. 1981;21(1):50–6.CrossRefPubMed Blackwell JN, Holt S, Heading RC. Effect of nifedipine on oesophageal motility and gastric emptying. Digestion. 1981;21(1):50–6.CrossRefPubMed
18.
Zurück zum Zitat Davies HA, Lewis MJ, Henderson AH. Trial of nifedipine for prevention of oesophageal spasm. Digestion. 1987;36(2):81–3.CrossRefPubMed Davies HA, Lewis MJ, Henderson AH. Trial of nifedipine for prevention of oesophageal spasm. Digestion. 1987;36(2):81–3.CrossRefPubMed
19.
Zurück zum Zitat Nasrallah SM, Tommaso CL, Singleton RT, Backhaus EA. Primary esophageal motor disorders: clinical response to nifedipine. South Med J. 1985;78(3):312–5.CrossRefPubMed Nasrallah SM, Tommaso CL, Singleton RT, Backhaus EA. Primary esophageal motor disorders: clinical response to nifedipine. South Med J. 1985;78(3):312–5.CrossRefPubMed
20.
Zurück zum Zitat Thomas E, Witt P, Willis M, Morse J. Nifedipine therapy for diffuse esophageal spasm. South Med J. 1986;79(7):847–9.CrossRefPubMed Thomas E, Witt P, Willis M, Morse J. Nifedipine therapy for diffuse esophageal spasm. South Med J. 1986;79(7):847–9.CrossRefPubMed
21.
Zurück zum Zitat Patti MG, Pellegrini CA, Arcerito M, Tong J, Mulvihill SJ, Way LW. Comparison of medical and minimally invasive surgical therapy for primary esophageal motility disorders. Arch Surg. 1995;130(6):609–15. discussion 15–6.CrossRefPubMed Patti MG, Pellegrini CA, Arcerito M, Tong J, Mulvihill SJ, Way LW. Comparison of medical and minimally invasive surgical therapy for primary esophageal motility disorders. Arch Surg. 1995;130(6):609–15. discussion 15–6.CrossRefPubMed
23.
Zurück zum Zitat Khan MA, Kumbhari V, Ngamruengphong S, Ismail A, Chen YI, Chavez YH, et al. Is POEM the answer for the management of spastic esophageal disorders? A systematic review and meta-analysis. Gastrointest Endosc. 2016;1:AB590–AB1.CrossRef Khan MA, Kumbhari V, Ngamruengphong S, Ismail A, Chen YI, Chavez YH, et al. Is POEM the answer for the management of spastic esophageal disorders? A systematic review and meta-analysis. Gastrointest Endosc. 2016;1:AB590–AB1.CrossRef
24.
Zurück zum Zitat Sharata AM, Dunst CM, Pescarus R, Shlomovitz E, Wille AJ, Reavis KM, et al. Peroral endoscopic myotomy (POEM) for esophageal primary motility disorders: analysis of 100 consecutive patients. J Gastrointest Surg. 2015;19(1):161–70. discussion 70.CrossRefPubMed Sharata AM, Dunst CM, Pescarus R, Shlomovitz E, Wille AJ, Reavis KM, et al. Peroral endoscopic myotomy (POEM) for esophageal primary motility disorders: analysis of 100 consecutive patients. J Gastrointest Surg. 2015;19(1):161–70. discussion 70.CrossRefPubMed
25.
Zurück zum Zitat Minami H, Isomoto H, Yamaguchi N, Ohnita K, Takeshima F, Inoue H, et al. Peroral endoscopic myotomy (POEM) for diffuse esophageal spasm. Endoscopy. 2014;46(Suppl 1 UCTN):E79–E81.PubMed Minami H, Isomoto H, Yamaguchi N, Ohnita K, Takeshima F, Inoue H, et al. Peroral endoscopic myotomy (POEM) for diffuse esophageal spasm. Endoscopy. 2014;46(Suppl 1 UCTN):E79–E81.PubMed
28.
Zurück zum Zitat Stavropoulos SN, Modayil RJ, Friedel D, Savides T. The International Per Oral Endoscopic Myotomy Survey (IPOEMS): a snapshot of the global POEM experience. Surg Endosc. 2013;27(9):3322–38.CrossRefPubMed Stavropoulos SN, Modayil RJ, Friedel D, Savides T. The International Per Oral Endoscopic Myotomy Survey (IPOEMS): a snapshot of the global POEM experience. Surg Endosc. 2013;27(9):3322–38.CrossRefPubMed
29.
Zurück zum Zitat Miller LS, Parkman HP, Schiano TD, Cassidy MJ, Ter RB, Dabezies MA, et al. Treatment of symptomatic nonachalasia esophageal motor disorders with botulinum toxin injection at the lower esophageal sphincter. Dig Dis Sci. 1996;41(10):2025–31.CrossRefPubMed Miller LS, Parkman HP, Schiano TD, Cassidy MJ, Ter RB, Dabezies MA, et al. Treatment of symptomatic nonachalasia esophageal motor disorders with botulinum toxin injection at the lower esophageal sphincter. Dig Dis Sci. 1996;41(10):2025–31.CrossRefPubMed
30.
Zurück zum Zitat Han JP, Hong SJ, Kim HI, Byun JM, Kim HJ, Ko BM, et al. Symptomatic improvement of diffuse esophageal spasm after botulinum toxin injection. Korean J Gastroenterol. 2012;60(2):109–12.CrossRefPubMed Han JP, Hong SJ, Kim HI, Byun JM, Kim HJ, Ko BM, et al. Symptomatic improvement of diffuse esophageal spasm after botulinum toxin injection. Korean J Gastroenterol. 2012;60(2):109–12.CrossRefPubMed
32.
Zurück zum Zitat Drenth JPH, Bos LP, Engels LGJB. Efficacy of diltiazem in the treatment of diffuse oesophageal spasm. Aliment Pharmacol Ther. 1990;4(4):411–6.CrossRefPubMed Drenth JPH, Bos LP, Engels LGJB. Efficacy of diltiazem in the treatment of diffuse oesophageal spasm. Aliment Pharmacol Ther. 1990;4(4):411–6.CrossRefPubMed
Metadaten
Titel
Systematic review and meta-analysis on the treatment of diffuse esophageal spasm
verfasst von
Harry Vercoe
Mubashir Mulla, MD
Wyn G. Lewis, FRCS
Antonio Foliaki, FRCS
David S. Y. Chan, FRCS
Publikationsdatum
01.03.2019
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 5/2019
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-019-0574-0

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