Efficacy and safety of peroral endoscopic myotomy in 100 older patients

Okada, Hiroki; Shiwaku, Hironari; Ohmiya, Toshihiro; Shiwaku, Akio; Hasegawa, Suguru

doi:10.1007/s10388-021-00881-7

Cited by 5 publications

(1 citation statement)

References 29 publications

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“…Literature reports that the mean age for patients with achalasia that undergo POEMs may range from 34 to 59 years, with a median age of approximately 51 years [ 20 , 21 ]. The procedure has been established to be highly effective and safe in the elderly demographic, thereby increasing its utilization in the subset population [ 22 , 23 ]. In our study, the mean age for achalasia patients that required hospitalization after POEM in the USA was 57.6 ± 0.9 years, with an increase in mean age for the 2016 - 2019 study period ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Complications for Achalasia Patients Admitted After Per-Oral Endoscopic Myotomy

et al. 2023

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Background Per-oral endoscopic myotomy (POEM) is a rapidly emerging minimally invasive procedure for management of achalasia. Same-day discharge after POEM is safe and feasible; however, some patients may need hospitalization. We aimed to identify characteristics and outcomes for achalasia patients requiring hospitalizations after POEM in the United States (US). Methods The US National Inpatient Sample was utilized to identify all adult achalasia patients who were admitted after POEM from 2016 to 2019. Hospitalization characteristics and clinical outcomes were highlighted. Results From 2016 to 2019, we found that 1,885 achalasia patients were admitted after POEM. There was an increase in the total number of hospitalizations after POEM from 380 in 2016 to 490 in 2019. The mean age increased from 54.2 years in 2016 to 59.3 years in 2019. Most POEM-related hospitalizations were for the 65 - 79 age group (31.8%), females (50.4%), and Whites (68.4%). A majority (56.2%) of the study population had a Charlson Comorbidity Index of 0. The Northeast hospital region had the highest number of POEM-related hospitalizations. Most of these patients (88.3%) were eventually discharged home. There was no inpatient mortality. The mean length of stay decreased from 4 days in 2016 to 3.2 days in 2019, while the mean total healthcare charge increased from $52,057 in 2016 to $65,109 in 2019. Esophageal perforation was the most common complication seen in 1.3% of patients. Conclusion The number of achalasia patients needing hospitalization after POEM increased. There was no inpatient mortality conferring an excellent safety profile of this procedure.

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