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2016 ; 2016
(ä): 2656101
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Two-Person Technique of Peroral Endoscopic Myotomy for Achalasia with an Advanced
Endoscopist and a Thoracic Surgeon: Initial Experience
#MMPMID27630977
Sanaka MR
; Jegadeesan R
; Thota PN
; Navaneethan U
; Lopez R
; Murthy SC
; Raja S
Can J Gastroenterol Hepatol
2016[]; 2016
(ä): 2656101
PMID27630977
show ga
Background and Aims. We initiated peroral endoscopic myotomy (POEM) utilizing a
two-person technique with combination of an advanced endoscopist and a thoracic
surgeon with complementary skills. Our aim was to determine the feasibility and
outcomes in initial 20 patients. Methods. In this observational study, main
outcomes measured were therapeutic success in relieving symptoms (Eckardt score <
3), decrease in lower esophageal sphincter (LES) pressures, improvement in
emptying on timed barium esophagogram (TBE), and complications. Results. POEM was
successful in all 20 patients with a mean operative time of 140.1 + 32.9 minutes.
Eckardt symptom scores decreased significantly at two-month follow-up (6.4 + 2.9
versus 0.25 + 0.45, p < 0.001). Both basal and residual LES pressures decreased
significantly (28.2 + 14.1?mmHg versus 12.8 + 6.3 and 22.4 + 11.3 versus 6.3 +
3.4?mmHg, p = 0.025 and <0.001, resp.). Barium column height at 5 minutes on TBE
reduced from 6.8 + 4.9?cm to 2.3 + 2.9?cm (p = 0.05). Two patients (10%) had
mucosal perforations and one had delayed bleeding (5%). Conclusions. Two-person
technique of POEM with combination of an advanced endoscopist and a thoracic
surgeon is highly successful with low risk of complications.