Introduction: Assessing esophageal clearance after peroral endoscopic myotomy (POEM) is essential for evaluating treatment success in achalasia. Timed barium esophagram (TBE) is the current standard, but high-resolution impedance manometry (HRiM) may provide a radiation-free physiological alternative.
Introduction:
Assessing esophageal clearance after peroral endoscopic myotomy (POEM) is essential for evaluating treatment success in achalasia. Timed barium esophagram (TBE) is the current standard, but high-resolution impedance manometry (HRiM) may provide a radiation-free physiological alternative.
Why was this study needed?
Although TBE is widely used after POEM, it requires repeated radiographic imaging and does not assess esophageal function in real time. This study evaluated whether HRiM could accurately assess esophageal clearance and predict long-term clinical outcomes.
What did the study show?
Clinical Impact:
HRiM provides a reliable physiological assessment of esophageal clearance after POEM and may reduce dependence on repeated radiographic studies. It can help identify patients who require closer follow-up or additional intervention.
Take-Home Message:
High-resolution impedance manometry is a reproducible and effective tool for evaluating esophageal clearance after POEM. Its excellent ability to exclude future treatment failure makes it a valuable addition to the long-term follow-up of patients with achalasia.
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