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Rethinking the need for overnight admission after peroral endoscopic myotomy (POEM): a pandemic-driven approach to the future
Background and study aims COVID-19 has significantly impacted endoscopic assessment and management of multiple conditions. Our group recommenced treatment of highly symptomatic achalasia patients (Eckardt score ≥ 6) adopting a same-day discharge (SDD) algorithm and present early outcomes of its uti...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8367444/ https://www.ncbi.nlm.nih.gov/pubmed/34466362 http://dx.doi.org/10.1055/a-1490-9385 |
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author | Zhang, Linda Y. Bejjani, Michael Ghandour, Bachir Khashab, Mouen A. |
author_facet | Zhang, Linda Y. Bejjani, Michael Ghandour, Bachir Khashab, Mouen A. |
author_sort | Zhang, Linda Y. |
collection | PubMed |
description | Background and study aims COVID-19 has significantly impacted endoscopic assessment and management of multiple conditions. Our group recommenced treatment of highly symptomatic achalasia patients (Eckardt score ≥ 6) adopting a same-day discharge (SDD) algorithm and present early outcomes of its utilization. Patients and methods We enrolled all outpatients undergoing POEM at a single tertiary referral center. Patients qualified for SDD if all of the following a priori criteria were met: 1) ASA grade I-III; 2) No intraprocedural adverse events (AEs); 3) Secure mucosal closure; 4) Post-procedure pain/nausea responsive to oral medications; and 5) Patients tolerating clear fluids. Results In 17 potential SDD candidates (female 82.4 %, median age 51 years [IQR 48–64]) undergoing POEM, SDD was achieved in 14 (82.4 %). The remaining were admitted due to post-procedure pain/nausea (n = 2) and intraprocedural concerns (capnoperitoneum requiring needle decompression, n = 1). There were no post-procedure AEs or unexpected readmissions. Conclusions This study demonstrates the safety and feasibility of a SDD algorithm for POEM patients and challenges the necessity of routine post-POEM hospital admission. Critically important during the COVID-19 pandemic, this may in fact constitute a changing standard for POEM post-procedure care. |
format | Online Article Text |
id | pubmed-8367444 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-83674442021-08-30 Rethinking the need for overnight admission after peroral endoscopic myotomy (POEM): a pandemic-driven approach to the future Zhang, Linda Y. Bejjani, Michael Ghandour, Bachir Khashab, Mouen A. Endosc Int Open Background and study aims COVID-19 has significantly impacted endoscopic assessment and management of multiple conditions. Our group recommenced treatment of highly symptomatic achalasia patients (Eckardt score ≥ 6) adopting a same-day discharge (SDD) algorithm and present early outcomes of its utilization. Patients and methods We enrolled all outpatients undergoing POEM at a single tertiary referral center. Patients qualified for SDD if all of the following a priori criteria were met: 1) ASA grade I-III; 2) No intraprocedural adverse events (AEs); 3) Secure mucosal closure; 4) Post-procedure pain/nausea responsive to oral medications; and 5) Patients tolerating clear fluids. Results In 17 potential SDD candidates (female 82.4 %, median age 51 years [IQR 48–64]) undergoing POEM, SDD was achieved in 14 (82.4 %). The remaining were admitted due to post-procedure pain/nausea (n = 2) and intraprocedural concerns (capnoperitoneum requiring needle decompression, n = 1). There were no post-procedure AEs or unexpected readmissions. Conclusions This study demonstrates the safety and feasibility of a SDD algorithm for POEM patients and challenges the necessity of routine post-POEM hospital admission. Critically important during the COVID-19 pandemic, this may in fact constitute a changing standard for POEM post-procedure care. Georg Thieme Verlag KG 2021-08-16 /pmc/articles/PMC8367444/ /pubmed/34466362 http://dx.doi.org/10.1055/a-1490-9385 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Zhang, Linda Y. Bejjani, Michael Ghandour, Bachir Khashab, Mouen A. Rethinking the need for overnight admission after peroral endoscopic myotomy (POEM): a pandemic-driven approach to the future |
title | Rethinking the need for overnight admission after peroral endoscopic myotomy (POEM): a pandemic-driven approach to the future |
title_full | Rethinking the need for overnight admission after peroral endoscopic myotomy (POEM): a pandemic-driven approach to the future |
title_fullStr | Rethinking the need for overnight admission after peroral endoscopic myotomy (POEM): a pandemic-driven approach to the future |
title_full_unstemmed | Rethinking the need for overnight admission after peroral endoscopic myotomy (POEM): a pandemic-driven approach to the future |
title_short | Rethinking the need for overnight admission after peroral endoscopic myotomy (POEM): a pandemic-driven approach to the future |
title_sort | rethinking the need for overnight admission after peroral endoscopic myotomy (poem): a pandemic-driven approach to the future |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8367444/ https://www.ncbi.nlm.nih.gov/pubmed/34466362 http://dx.doi.org/10.1055/a-1490-9385 |
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