383 Per Oral Endoscopic Myotomy (POEM), A Five-Year Analysis at UHNM

Résumé fourni par la source

Abstract Aim Achalasia is a rare but debilitating condition causing dysphagia, regurgitation, weight loss and has a significant reduction in quality of life. Our aim was to assess the success of POEM both as a primary treatment and where previous attempts have failed (i.e.. Following a Hellers procedure). Method A cohort of 80 patients undergoing primary POEM (PP) and a second undergoing POEM post Hellers procedure (PPH) were followed over a 5-year period for procedure success and procedure related complications. Procedure success was determined by a reduction in Eckhard score of below 3 a reduction in the use of proton pump inhibitors (PPI) and no complications. Results The PP cohort had a higher pre procedure Eckhard score of 8 (vs 5 for PPH). 92% of patients in PP group achieved an Eckhard score of <3 (100% after repeat POEM) compared to 100% in PPH. Complications were rare (1% leaks, 1% bleeding and 1% infection) for the PP cohort with no cases for the PPH group. There were two readmissions (PP group) and mortality was zero for both groups. Only 3% of repeat procedures were required (PP group) to achieve symptom control. PPI use was reduced by 8% in PP cohort (from 57% to 49%) but was unchanged in the PPH group (62%). Conclusions PP and PPH are highly effective, achieving excellent symptom control and reduction in use of PPIs in all but the most aggressive cases. It has a low complication rate and is safe even when previous attempts at treatment have failed.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.