Per-Oral Endoscopic Myotomy for the treatment of non-achalasia esophageal dysmotility disorders: Experience from a single high-volume center
Timothy J. Morley1, Matthew F. Mikulski1, Matthew Rade1, Jean Chalhoub2, David Desilets2, John Romanelli1
1Surgery, University of Massachusetts Medical School - Baystate Medical Center, Springfield, Massachusetts, United States, 2Gastroenterology, University of Massachusetts Medical School - Baystate Medical Center, Springfield, Massachusetts, United States
Present our experience treating non-achalasia esophageal dysmotility disorders with Per-Oral Endoscopic Myotomy (POEM), demonstrating safety and efficacy.
Tertiary referral academic medical center
Consecutive series who underwent POEM for non-achalasia esophageal dysmotility disorders.
POEM was performed by a surgeon-endoscopist pair under general anesthesia. A gastroscope was used to identify the gastroesophageal junction (EGJ), create a submucosal tunnel and perform myotomy proximal to the EGJ and extending at least 2cm distal to the EGJ.
6. MAIN OUTCOME MEASURES:
Primary: Symptom resolution measured by Eckardt Score
Secondary: Indication, myotomy length, conversion to laparoscopic procedure, operative time, length of stay (LOS)
Included 17 adults, mean age 62.5 ± 10.9 years. One case of nutcracker esophagus was aborted and excluded from statistical analysis. Of the remaining 16 cases, 9 were performed for EGJ outflow obstruction, 6 for jackhammer esophagus, and 1 for distal esophageal spasm. Average BMI was 27.9 ± 6. Average preoperative Eckardt score was 7 ± 2. Average myotomy length was 10.4 ± 1.7cm. Pneumoperitoneum was encountered twice. LOS was 1.3 ± 1.0 days, and average operative time was 79.9 ± 25.6 minutes. Two additional cases failed but were included in analysis. Postoperative Eckart score was 1.33 ± 2.2. There were no conversions to open surgery, or patient deaths.
POEM is a safe, minimally invasive procedure and can be an effective treatment for a broad scope of esophageal dysmotility disorders in experienced hands.
Back to 2021 Posters