36 Participants Needed

U-POEM vs CO2-POEM for Esophageal Motility Disorder

(U-POEM Trial)

BC
PT
Overseen ByPetronio T Senior Clinical Research Operations Manager, MHA
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: AdventHealth
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial compares two methods for performing a procedure called POEM, used to treat esophageal motility disorders (problems with how the esophagus moves food). One method, CO2-POEM, uses carbon dioxide gas, while the other, U-POEM, uses water immersion. The trial aims to determine which method results in less pain after the procedure and requires fewer pain medications. It will also evaluate other factors, such as the procedure's success and the need for hospital admission afterward. Suitable candidates for this trial are those scheduled for a POEM procedure due to esophageal dysmotility (difficulty swallowing or moving food down the esophagus). As an unphased trial, this study offers patients the chance to contribute to medical knowledge and potentially benefit from innovative treatment methods.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

In earlier studies, U-POEM has shown great success with few side effects. One study demonstrated that U-POEM was effective for 95.7% of patients after three months, with minimal complications. Another study confirmed its effectiveness and safety, yielding good results for patients.

For CO2-POEM, research also indicates it is safe and effective. Patients can safely return home the same day after the procedure, and studies have reported a success rate between 90.8% and 100% in older patients. Some studies mention possible minor issues like air leaks, which are usually easy to manage.

Both techniques are generally well-tolerated, with only a few minor risks.12345

Why are researchers excited about this trial?

Researchers are excited about the U-POEM and CO2-POEM techniques for treating esophageal motility disorders because they offer unique approaches to improving patient outcomes. Unlike traditional methods that typically use carbon dioxide insufflation, U-POEM employs water immersion to distend the gastrointestinal tract, potentially reducing the risk of gas-related complications and improving visualization during the procedure. CO2-POEM, on the other hand, utilizes carbon dioxide, which is absorbed more rapidly than air, minimizing patient discomfort and reducing recovery time. These innovative techniques could lead to safer and more effective treatment options for patients with esophageal motility disorders.

What evidence suggests that this trial's treatments could be effective for esophageal motility disorder?

This trial compares two methods of Peroral Endoscopic Myotomy (POEM) for treating swallowing disorders: CO2-POEM and U-POEM. Research has shown that POEM effectively relieves symptoms in the short term for 90% to 100% of patients and over 80% in the long term. In this trial, the CO2-POEM method uses carbon dioxide for insufflation, which reduces gas-related issues due to the rapid absorption of the gas. Meanwhile, U-POEM, another method under study, uses water instead of gas, achieving high success rates and avoiding gas-related problems. Both methods are safe and effective, but U-POEM may offer additional benefits, such as improved patient comfort.678910

Who Is on the Research Team?

DY

Dennis Yang, MD

Principal Investigator

AdventHealth Medical Group

Are You a Good Fit for This Trial?

This trial is for individuals with Nutcracker Esophagus, Esophageal Spasm, or other Esophageal Motility Disorders. Participants will be chosen based on specific inclusion and exclusion criteria that are not detailed here.

Inclusion Criteria

Ability to provide informed consent
I am scheduled for a POEM procedure for esophagus issues.

Exclusion Criteria

I am unable to understand or sign the consent form.
I have no health conditions that prevent me from safely undergoing anesthesia or a colonoscopy.
I have no conditions that would prevent me from having a POEM procedure.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo Per-Oral Endoscopic Myotomy (POEM) using either CO2 or water immersion for luminal distension

1 day
1 visit (in-person)

Post-procedural Monitoring

Participants are monitored for post-procedural pain and other outcomes using Numeric Pain Scale and Pain Quality Assessment Scale

1 day
1 visit (in-person)

Follow-up

Participants are monitored for safety, effectiveness, and readmission rates up to 6 months post-procedure

6 months
1 visit (in-person), additional follow-up as needed

What Are the Treatments Tested in This Trial?

Interventions

  • CO2-POEM
  • U-POEM
Trial Overview The study compares two methods of Per-Oral endoscopic myotomy (POEM) for esophageal conditions: CO2-POEM using carbon dioxide gas and U-POEM using underwater immersion. It aims to assess post-procedural pain, hospital admissions for pain management, analgesic needs, procedure success rates, and procedural characteristics.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: U-POEMExperimental Treatment1 Intervention
Group II: CO2-POEMExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

AdventHealth

Lead Sponsor

Trials
118
Recruited
31,800+

Mayo Clinic

Collaborator

Trials
3,427
Recruited
3,221,000+

University of Florida

Collaborator

Trials
1,428
Recruited
987,000+

California Pacific Medical Center

Collaborator

Trials
13
Recruited
8,200+

Citations

Prospective evaluation of the efficacy of peroral ...In this study, we investigated the efficacy and clinical outcomes of POEM for treatment of achalasia. POEM achieved symptom relief, and therefore was clinically ...
Per-oral endoscopic myotomy (POEM) for achalasiaClinical series have reported a 37% response at 3 years with a single balloon dilation vs. 86% with graded dilations and that balloon dilation is more ...
Effect of peroral endoscopic myotomy on growth and ...In conclusion, this study demonstrated that the POEM procedure was a safe and effective treatment for pediatric patients with achalasia in Taiwan. The procedure ...
U-POEM vs CO2-POEM for Esophageal Motility DisorderPOEM (Peroral Endoscopic Myotomy) is generally considered safe for treating esophageal motility disorders, with studies showing successful outcomes and ...
Peroral Endoscopic Myotomy for Treatment of AchalasiaOur results showed that POEM resulted in a significant decrease in the achalasia symptom score. Both mean LES pressure and IRP were significantly improved in ...
Study Details | NCT06918730 | U-POEM vs CO2-POEMSame-day discharge is safe and feasible following POEM surgery for esophageal motility disorders. Surg Endosc. 2021 Jul;35(7):3398-3404. doi: 10.1007/s00464 ...
Efficacy and Safety of Peroral Endoscopic Myotomy for ...The short-term clinical success rate of POEM in elderly patients has been reported to be 90.8–100% [17,18,19], and was 100% in this study. In ...
Peroral endoscopic myotomy safety dataFew significant complications have been reported in the literature including aspiration pneumonia, mediastinal hematoma, delayed hemorrhage, pneumothorax, ...
Peroral endoscopic myotomy (POEM) for the treatment of ...Conclusions: POEM appears to be a safe and effective endoscopic treatment, alternative to laparoscopic Heller myotomy in the treatment of achalasia. However, ...
Peroral endoscopic myotomy safety dataPneumomediastinum and cervical emphysema are frequent during POEM. They are caused by the insufflation of carbon dioxide into the mediastinum during the ...
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