The POEM papers keep coming....
- Dr. Steven Horwitz
- Oct 24, 2015
- 2 min read
This study followed 23 sigmoid-type achalasia patients after POEM for 18 months. The surgery took an average of 67.6 minutes.
I always find comments like this amusing:
"Overall treatment success was achieved in 95.6% of the patients (22/23), and morphological improvement was observed in 95% (19/20) of the patients."
But... "In 10 patients (43.5%) complications were encountered, including gas-related complications, mucosal perforation, and reflux esophagitis."
At least the conclusion was honest: "Yet, further experiences and long-term results are warranted."
"Most centers perform a routine esophagram on postoperative day (POD) #1 to rule esophageal perforation and leaks. In this study, we sought to determine the clinical utility of routine contrast studies post-POEM."
"Overall, 56 patients had abnormal studies. POD #1 esophagram demonstrated a sensitivity of 100 % and specificity of 45 % in identifying clinically significant complications.
CONCLUSIONS: In this series, we found routine esophagram to have a high sensitivity but a very low specificity in detecting clinically significant complications. Routine esophagram after POEM may not be necessary."
This paper's conclusion is a bit puzzling given the number of post POEM abnormal studies. Wouldn't you want to check your work? I will take the radiation exposure to make sure all is OK.
Make the EGJ junction larger and you get a better outcome. OK, no big news on this one.
"Of the 63 treated patients, 50 had good and 13 had poor clinical response." Not great....
Remember, surgery does not address the root cause of Achalasia.
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