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Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video)

BACKGROUND/AIMS: Peroral endoscopic myotomy (POEM) has recently come to the forefront in the management of achalasia. We aimed to analyze the efficacy and safety of the use of electrocautery enhanced scissors (EES) for POEM. METHODS: This retrospective cohort study prospectively collected the data o...

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Autores principales: Hathorn, Kelly E., Chan, Walter W., Aihara, Hiroyuki, Thompson, Christopher C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Gastrointestinal Endoscopy 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7403010/
https://www.ncbi.nlm.nih.gov/pubmed/32438778
http://dx.doi.org/10.5946/ce.2019.214
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author Hathorn, Kelly E.
Chan, Walter W.
Aihara, Hiroyuki
Thompson, Christopher C.
author_facet Hathorn, Kelly E.
Chan, Walter W.
Aihara, Hiroyuki
Thompson, Christopher C.
author_sort Hathorn, Kelly E.
collection PubMed
description BACKGROUND/AIMS: Peroral endoscopic myotomy (POEM) has recently come to the forefront in the management of achalasia. We aimed to analyze the efficacy and safety of the use of electrocautery enhanced scissors (EES) for POEM. METHODS: This retrospective cohort study prospectively collected the data of all adult patients (aged ≥18 years) with normal foregut anatomy who underwent POEM using EES. The patients’ baseline characteristics and procedure details (time, tunnel length, myotomy length, depth, and location) were recorded. The primary outcome was clinical success (3-month post-procedure Eckardt score of ≤3). The secondary outcomes were technical success and adverse events. A paired Student’s t-test was performed. RESULTS: Fifteen patients were included in this study. The technical success rate of myotomy using EES was 100%. Fellows participated in the myotomy in all cases. The clinical success rate was 93.3% (14/15). The mean pre-Eckardt score was 5.4±2.5, while the mean post-Eckardt score was 1.3±1.3, which indicated a significant improvement (p≤0.0001). The most common treatment-related adverse events were post-procedure pain (4, 26.7%) and symptomatic reflux disease (4, 26.7%). CONCLUSIONS: In the largest series to date on the use of EES in POEM, we demonstrated that this technique has both technical and clinical efficacy as well as an excellent safety profile.
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spelling pubmed-74030102020-08-11 Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video) Hathorn, Kelly E. Chan, Walter W. Aihara, Hiroyuki Thompson, Christopher C. Clin Endosc Original Article BACKGROUND/AIMS: Peroral endoscopic myotomy (POEM) has recently come to the forefront in the management of achalasia. We aimed to analyze the efficacy and safety of the use of electrocautery enhanced scissors (EES) for POEM. METHODS: This retrospective cohort study prospectively collected the data of all adult patients (aged ≥18 years) with normal foregut anatomy who underwent POEM using EES. The patients’ baseline characteristics and procedure details (time, tunnel length, myotomy length, depth, and location) were recorded. The primary outcome was clinical success (3-month post-procedure Eckardt score of ≤3). The secondary outcomes were technical success and adverse events. A paired Student’s t-test was performed. RESULTS: Fifteen patients were included in this study. The technical success rate of myotomy using EES was 100%. Fellows participated in the myotomy in all cases. The clinical success rate was 93.3% (14/15). The mean pre-Eckardt score was 5.4±2.5, while the mean post-Eckardt score was 1.3±1.3, which indicated a significant improvement (p≤0.0001). The most common treatment-related adverse events were post-procedure pain (4, 26.7%) and symptomatic reflux disease (4, 26.7%). CONCLUSIONS: In the largest series to date on the use of EES in POEM, we demonstrated that this technique has both technical and clinical efficacy as well as an excellent safety profile. Korean Society of Gastrointestinal Endoscopy 2020-07 2020-05-22 /pmc/articles/PMC7403010/ /pubmed/32438778 http://dx.doi.org/10.5946/ce.2019.214 Text en Copyright © 2020 Korean Society of Gastrointestinal Endoscopy This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hathorn, Kelly E.
Chan, Walter W.
Aihara, Hiroyuki
Thompson, Christopher C.
Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video)
title Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video)
title_full Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video)
title_fullStr Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video)
title_full_unstemmed Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video)
title_short Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video)
title_sort determining the safety and effectiveness of electrocautery enhanced scissors for peroral endoscopic myotomy (with video)
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7403010/
https://www.ncbi.nlm.nih.gov/pubmed/32438778
http://dx.doi.org/10.5946/ce.2019.214
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