Per oral endoscopic myotomy: early experience and safety of a multispecialty approach

Per oral endoscopic myotomy: early experience and safety of a multispecialty approach Background Per oral endoscopic myotomy (POEM) has gained increasing popularity for treating achalasia. A multidisci- plinary approach may allow safe and early adoption of POEM into clinical practice. Materials and methods We performed a retrospective review of our initial POEM cases. All procedures were performed by a team of interventional gastroenterologist and thoracic surgeon. We analyzed demographics, comorbidities, achalasia subtypes, length of hospital stay, duration of surgery, morbidity, mortality, length of myotomy, preoperative and postopera- tive Eckardt scores. Results Thirty-one consecutive patients underwent POEM during the 24-month period from January 2014 to December 2015. Eighteen patients (58%) had prior non-operative interventions. Average duration of follow-up was 9.6 months. Sev- enteen patients (66.8%) had follow-up of 12 months and longer. Average preoperative Eckardt score was 6.3 (3–10), median 6. Average postoperative Eckardt score was 1.4 (0–8), median 1, in 1 month and an average 2.2, median 1, in 1 year. Patients with type III achalasia were most refractory to treatment, while patients with type II had the best results. Average LOS was 1.3 days (1–5), median 1 day. Average DOS was 106 min (60–148), median 106. Average LOM was 13 cm (10–15), with median of 13 cm. We had one 30-day mortality secondary to coronary artery disease. Four patients http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Surgical Endoscopy Springer Journals

Per oral endoscopic myotomy: early experience and safety of a multispecialty approach

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Publisher
Springer US
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Surgery; Gynecology; Gastroenterology; Hepatology; Proctology; Abdominal Surgery
ISSN
0930-2794
eISSN
1432-2218
D.O.I.
10.1007/s00464-018-6056-9
Publisher site
See Article on Publisher Site

Abstract

Background Per oral endoscopic myotomy (POEM) has gained increasing popularity for treating achalasia. A multidisci- plinary approach may allow safe and early adoption of POEM into clinical practice. Materials and methods We performed a retrospective review of our initial POEM cases. All procedures were performed by a team of interventional gastroenterologist and thoracic surgeon. We analyzed demographics, comorbidities, achalasia subtypes, length of hospital stay, duration of surgery, morbidity, mortality, length of myotomy, preoperative and postopera- tive Eckardt scores. Results Thirty-one consecutive patients underwent POEM during the 24-month period from January 2014 to December 2015. Eighteen patients (58%) had prior non-operative interventions. Average duration of follow-up was 9.6 months. Sev- enteen patients (66.8%) had follow-up of 12 months and longer. Average preoperative Eckardt score was 6.3 (3–10), median 6. Average postoperative Eckardt score was 1.4 (0–8), median 1, in 1 month and an average 2.2, median 1, in 1 year. Patients with type III achalasia were most refractory to treatment, while patients with type II had the best results. Average LOS was 1.3 days (1–5), median 1 day. Average DOS was 106 min (60–148), median 106. Average LOM was 13 cm (10–15), with median of 13 cm. We had one 30-day mortality secondary to coronary artery disease. Four patients

Journal

Surgical EndoscopySpringer Journals

Published: Jan 18, 2018

References

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