Per Rectal Endoscopic Myotomy (Prem) for Infantile Hirschsprung's Disease

Bapaye, Amol; Mahadik, Mahesh; Korrapati, Sravan Kumar; Nemade, Pankaj; Pujari, Rajendra; Date, Suhas; Dubale, Nachiket; Bapaye, Jay

doi:10.1055/s-0038-1637246

Cited by 5 publications

(4 citation statements)

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“…Third-space endoscopy permits performance of longer or tailor-made myotomy, as is evident from peroral endoscopic myotomy (POEM) for achalasia cardia and G-POEM for gastroparesis. Based on this philosophy, per-rectal endoscopic myotomy (PREM) was conceptualized, successfully performed, and reported by the authors' group in the form of two case reports and one conference abstract on adults followed by pediatric and infantile SS-HSCR patients [9][10][11]. The current case series reports a single-center experience of PREM for SS-HSCR patients with medium-term to long-term follow-up.…”

Section: Table S1 S2mentioning

confidence: 99%

“…Based on this philosophy, per rectal endoscopic myotomy (PREM) was conceptualized, successfully performed and reported by the authors' group as two case reports and one conference abstract of adult followed by pediatric and infantile SS-HSCR patients. [9][10][11] The current case series reports a single-center experience of PREM for SS-HSCR patients with medium to long-term follow up.…”

Section: Introductionmentioning

confidence: 99%

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Initial experience with per-rectal endoscopic myotomy for Hirschsprung’s disease: medium and long term outcomes of the first case series of a novel third-space endoscopy procedure

et al. 2020

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Introduction Hirschsprung’s disease (HSCR) is congenital aganglionosis affecting hindgut and presents with constipation. Surgical pull-through is current standard but has morbidity. Per-rectal endoscopic myotomy (PREM) is a novel third space endoscopy technique for treating SS-HSCR. Methods Retrospective series of SS-HSCR patients diagnosed on history, contrast enema, rectal biopsies, anorectal manometry and treated by PREM. Aganglionic segment mapped pre-PREM. PREM performed using third space endoscopy principles. Objective – to compare stool frequency and unit laxative (UL) usage pre and post-PREM. Results N = 9; duration 4-years. Mean age – 7.5 (± 5.2) years; 7 males. Mean aganglionic segment length – 6.3 (± 4.4) cm. Mean procedure time – 96.1 (±37.9) minutes. Mean LOS – 2.5 (±0.7) days. Median follow-up –17 months (9 – 58). Stool frequency – pre – 1/4.4 (±1.5) vs. post – 1/1.2 (±0.4) days (p = 0.0004). Mean UL usage – pre – 5.4 (±4.9) vs. post – 0.4 (±0.7) units (p = 0.0002). No laxatives in 6 (66%). Single AE (anal stenosis) – dilatation. Conclusions PREM is a safe and effective minimally invasive procedure for SS-HSCR and provides long-term response.

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Section: Table S1 S2mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Initial experience with per-rectal endoscopic myotomy for Hirschsprung’s disease: medium and long term outcomes of the first case series of a novel third-space endoscopy procedure

et al. 2020

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“…87 After the initial description of per-anal endoscopic myotomy in a porcine model, 88 Bapaye et al 89 performed the first successful per-rectal endoscopic myotomy (PREM) in an 24-yearold adult patient with Hirschsprung's disease. The same group published case reports of successful PREM in a pediatric patient (8 years old) 90 and an infantile patient (2 years old). 91 With more evidence, the same technique can perhaps be expanded to manage other lower GI motility disorders such as hypertensive anal sphincter and sphincter dyssynergia.…”

Section: Gi Tractmentioning

confidence: 99%

“…The same group published case reports of successful PREM in a pediatric patient (8 years old) 90 and an infantile patient (2 years old). 91 With more evidence, the same technique can perhaps be expanded to manage other lower GI motility disorders such as hypertensive anal sphincter and sphincter dyssynergia.…”

Section: Gi Tractmentioning

confidence: 99%

Third space endoscopy: Current evidence and future development

Liu

Chiu

2020

Int J Gastrointest Interv

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Therapeutic endoscopy has evolved tremendously over the past decades and the development of submucosal endoscopy opens the third space for treatment of gastrointestinal diseases. This review focused on the recent development in third space endoscopy, with introduction of its development from peroral endoscopic myotomy (POEM) to beyond. Two recent randomized trials comparing POEM against pneumatic dilation and laparoscopic Heller myotomy (LHM) demonstrated significantly better relief of dysphagia for POEM compared to pneumatic dilation, while POEM achieved similar outcomes compared to LHM. Apart from achalasia, third space endoscopy is now developed to manage spastic esophageal motility disorders, esophageal diverticular diseases, gastroparesis, and Hirschsprung's disease. Subepithelial tumors can also be resected through tunneling and endoscopic fullthickness resection. In future, third space endoscopy will be one of the major areas in development of diagnostic and therapeutic endoscopy using novel imaging technologies and therapeutic devices.

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Per-Oral Endoscopic Pyloromyotomy (G-POEM) and Per-Rectal Endoscopic Myotomy (PREM)

Bapaye

Maydeo

2019

Gastrointestinal Interventional Endoscopy

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Per Rectal Endoscopic Myotomy (Prem) for Infantile Hirschsprung's Disease

Cited by 5 publications

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Initial experience with per-rectal endoscopic myotomy for Hirschsprung’s disease: medium and long term outcomes of the first case series of a novel third-space endoscopy procedure

Initial experience with per-rectal endoscopic myotomy for Hirschsprung’s disease: medium and long term outcomes of the first case series of a novel third-space endoscopy procedure

Third space endoscopy: Current evidence and future development

Per-Oral Endoscopic Pyloromyotomy (G-POEM) and Per-Rectal Endoscopic Myotomy (PREM)

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