POEM Versus Pneumatic Dilatation in Achalasia Cardia

NCT ID: NCT02025790

Last Updated: 2014-01-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-12-31

Study Completion Date

2015-12-31

Brief Summary

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The aim of this study is to compare efficacy of POEM and pneumatic dilatation in treatment of achalasia cardia.

Detailed Description

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Achalasia is an esophageal motility disorder which involves smooth muscle of the esophagus and the lower esophageal sphincter (LES). Achalasia causes difficulty swallowing, regurgitation, and sometimes chest pain and weight loss. Endoscopic treatments of achalasia can be provided in the form of dilatation of the LES or cutting of muscle fibers (myotomy) of the esophagus and of the LES under endoscopic viewing. Dilatation in this trial is accomplished with rigiflex balloons and myotomy via Per Oral Endoscopic Myotomy (POEM). The effectiveness of treatment of achalasia using each method will be compared in this trial.

Conditions

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Achalasia Cardia

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A - POEM

Per Oral Endoscopic Myotomy for treatment of achalasia

Group Type EXPERIMENTAL

Per Oral Endoscopic Myotomy (POEM)

Intervention Type PROCEDURE

* Mucosal incision - After submucosal injection, a 2-cm longitudinal mucosal incision is made at approximately 12 cm proximal to the gastroesophageal junction (GEJ).
* Submucosal tunneling. A long submucosal tunnel is created to 3 cm distal to the GEJ.
* Endoscopic myotomy is begun at 3 cm distal to the mucosal entry point, and is carried out in a proximal to distal direction to a total length of 10 cm.
* Long endoscopic myotomy is performed 10 cm proximal to GEJ extending
* Closure of mucosal entry: the mucosal incision is closed using hemostatic clips

Group B - Dilatation

\- Pneumatic dilatation using a balloon for treatment of achalasia.

Group Type ACTIVE_COMPARATOR

Pneumatic Dilatation

Intervention Type PROCEDURE

Pneumatic dilatation using a Rigiflex balloon up to 35 mm at 8 psi for 1 minute.

Interventions

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Per Oral Endoscopic Myotomy (POEM)

* Mucosal incision - After submucosal injection, a 2-cm longitudinal mucosal incision is made at approximately 12 cm proximal to the gastroesophageal junction (GEJ).
* Submucosal tunneling. A long submucosal tunnel is created to 3 cm distal to the GEJ.
* Endoscopic myotomy is begun at 3 cm distal to the mucosal entry point, and is carried out in a proximal to distal direction to a total length of 10 cm.
* Long endoscopic myotomy is performed 10 cm proximal to GEJ extending
* Closure of mucosal entry: the mucosal incision is closed using hemostatic clips

Intervention Type PROCEDURE

Pneumatic Dilatation

Pneumatic dilatation using a Rigiflex balloon up to 35 mm at 8 psi for 1 minute.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Achalasia with Eckardt score at least 3 (0-12 scale achalasia least-most severe)
2. Age 18-75 years
3. Willing and able to comply with the study procedures and provide written informed consent form to participate in the study written informed consent form to participate in the study

Exclusion Criteria

1. Severe comorbid illness
2. Previous esophageal or gastric surgery
3. Pseudo achalasia
4. Achalasia with esophageal diverticula
5. Pregnancy or lactation
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Asian Institute of Gastroenterology, India

OTHER

Sponsor Role lead

Responsible Party

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Nageshwar Reddy D

Chairman

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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D Nageshwar Reddy, MD

Role: PRINCIPAL_INVESTIGATOR

Asian Institute of Gastroenterology (AIG)

Locations

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Asian Institute of Gastroenterology

Hyderabad, Andhra Pradesh, India

Site Status RECRUITING

Countries

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India

Central Contacts

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D Nageshwar Reddy, MD

Role: CONTACT

+914023378888

Facility Contacts

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D Nageshwar Reddy, MD

Role: primary

+914023378888

Mohan Ramchandani, MD

Role: backup

+914023378888

Other Identifiers

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AIG-POEM-01

Identifier Type: -

Identifier Source: org_study_id

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