Is Peroral Endoscopic Myotomy for Achalasia Safe in a Small-Volume Center?

Rushfeldt C, Nordbø M and Goll R

Deptartment of Gastrointestinal Surgery, University Hospital of North Norway, Norway
Deptartment of Gastrointestinal Medicine, University Hospital of North Norway, Norway

^*Correspondance to: Christian Rushfeldt 

 PDF  Full Text DOI: 10.25107/2474-1647.1993

Abstract

Background and Aims: Peroral endoscopic myotomy (POEM) is a minimally invasive procedure for the surgical treatment of achalasia and an endoscopic alternative to open or laparoscopic Heller myotomy (HM). POEM was initially developed in Japan, was first published in 2010, and has since been increasingly adopted in Western countries. The aim of this study is to present preliminary data from the introductory phase of POEM in a small-volume center.Material and
Methods: The first 14 patients operated with POEM for achalasia at the University Hospital of North Norway were registered in a prospective database and retrospectively evaluated, as a quality assurance study. Indications for the procedures were manometric diagnosis of achalasia and a significant Eckardt symptom score (≥ 7 points).Results: A total of fourteen patients, 6 female, median age 47 years (19-77 years), were operated in a day care unit and observed in the hospital ward for a median of 1 day (1-17 days). The preoperative and three month postoperative follow-up median Eckardt symptom scores were 8 (7-12) and 0 (0- 9), respectively. One complication was encountered, which resulted in an intraoperative mucosal perforation, and was subsequently treated with an endoscopically implanted stent. Four patients reported acquiring occasional gastro esophageal reflux disease (GERD), which did not necessitate regular antacid medication.Conclusion: Preliminary results from the introductory phase of POEM for achalasia in a small volume center demonstrate that the procedure was performed safely and with satisfactory short term results.

Keywords

Per oral endoscopic myotomy; POEM; Achalasia

Cite the article

Rushfeldt C, Nordb� M, Goll R. Is Peroral Endoscopic Myotomy for Achalasia Safe in a Small-Volume Center? Clin Surg. 2018; 3: 1993.