Two-Person Technique of Peroral Endoscopic Myotomy for Achalasia with an Advanced Endoscopist and a Thoracic Surgeon: Initial Experience. (17th August 2016)

• Record Type: Journal Article
• Authors: Sanaka, Madhusudhan R.; Jegadeesan, Ramprasad; Thota, Prashanthi N.; Navaneethan, Udayakumar; Lopez, Rocio; Murthy, Sudish C.; Raja, Siva
• Other Names: Beyak Michael Academic Editor.
• Is Part Of: Canadian journal of gastroenterology & hepatology. Volume 2016(2016)
• Publication Date: 2016-08-17
• Subjects: Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Canada; Digestive System Diseases -- Periodicals; Gastroenterology -- Periodicals; Periodicals; Electronic journals; Fulltext; Internet Resources; Periodicals; 616.3
• DOI: 10.1155/2016/2656101
• Languages: English
• ISSNs: 2291-2789

Abstract

Abstract : 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 of140.1 + 32.9 minutes. Eckardt symptom scores decreased significantly at two-month follow-up (6.4 + 2.9 versus0.25 + 0.45, p < 0.001 ). Both basal and residual LES pressures decreased significantly (28.2 + 14.1 mmHg versus12.8 + 6.3 and22.4 + 11.3 versus6.3 + 3.4 mmHg, p = 0.025 and <0.001, resp.). Barium column height at 5 minutes on TBE reduced from6.8 + 4.9 cm to2.3 + 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.