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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, MD Mubashir Mulla, FRCS Wyn G. Lewis, FRCS Antonio Foliaki, FRCS David S. Y. Chan

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.
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Metadaten
Titel
Systematic review and meta-analysis on the treatment of diffuse esophageal spasm
verfasst von
Harry Vercoe
MD Mubashir Mulla
FRCS Wyn G. Lewis
FRCS Antonio Foliaki
FRCS David S. Y. Chan
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