Peroral endoscopic myotomy: a two-center retrospective study of practice and adverse events.

IF 1.3 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Acta gastro-enterologica Belgica Pub Date : 2024-01-01 DOI:10.51821/87.1.12358
C Van Severen, S Koch, J Faure, M Poncin, J-P Loly
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Abstract

Background and study aims: Peroral endoscopic myotomy (POEM) is the preferred technique for the treatment of esophageal motility disorders and is less invasive than surgery. This study was performed to compare two university centers in the practice of POEM, in terms of efficacy and adverse events, for the treatment of esophageal motility disorder.

Patients and methods: Retrospective comparative study of patients undergoing a POEM between September 2020 and December 2022 from the University Hospital of Liège (Belgium) and Besançon (France). The clinical success was defined by an Eckardt score ≤ 3 after the procedure.

Results: Fifty-five patients were included. In both centers, 87,3% of the patients had achalasia (mostly type II), and 12,7% had another esophageal motility disorder. The use of antibiotic prophylaxis was systematic in Liège center but not in Besançon center (100% and 9.1% respectively). The mean value of the post-operative Eckardt score was 1.55± 2.48 in both center with 93.2% of patients with a score ≤ 3 (92% in Besançon and 94.74% in Liège). The rate of adverse event was generally low. There were two minor adverse events more frequent in Liège, clinical capnomediastinum and pain at day one, but they were managed with conservative treatment. Only 7.3% of the total patients had an infectious phenomenon that did not correlate with the use of antibiotic prophylaxis.

Conclusion: The post-operative Eckardt score and the adverse event rate were comparable between the university centers. This study confirmed that POEM is a safe and effective technique. It also showed that using an antibiotic prophylaxis does not influence the development of infectious adverse events.

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口腔内窥镜肌切开术:一项关于实践和不良事件的双中心回顾性研究。
背景和研究目的:口周内镜下肌切开术(POEM)是治疗食管运动障碍的首选技术,其创伤小于外科手术。本研究旨在比较两所大学中心采用口周内镜下肌切开术治疗食管运动障碍的疗效和不良反应:对比利时列日大学医院和法国贝桑松大学医院在2020年9月至2022年12月期间接受POEM手术的患者进行回顾性比较研究。临床成功的定义是术后埃卡评分≤3分:结果:共纳入55名患者。在这两个中心,87.3%的患者患有贲门失弛缓症(多为 II 型),12.7%的患者患有其他食道运动障碍。列日中心系统性地使用了抗生素预防,贝桑松中心则没有(分别为100%和9.1%)。两家中心的术后Eckardt评分均值为1.55±2.48分,93.2%的患者评分小于3分(贝桑松中心为92%,列日中心为94.74%)。不良反应发生率普遍较低。在列日,有两种较常见的轻微不良反应,即临床上的胸腔积液和第一天的疼痛,但都通过保守治疗得到了控制。只有 7.3% 的患者出现了感染现象,但与使用抗生素预防无关:结论:各大学中心的术后 Eckardt 评分和不良事件发生率相当。这项研究证实,POEM 是一种安全有效的技术。研究还表明,使用抗生素预防不会影响感染性不良事件的发生。
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来源期刊
Acta gastro-enterologica Belgica
Acta gastro-enterologica Belgica Medicine-Gastroenterology
CiteScore
2.30
自引率
20.00%
发文量
78
期刊介绍: The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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