Efficacy and safety of per-oral endoscopic myotomy for the treatment of achalasia cardia in Malaysia: a single centre study

Nik Muhamad Affendi, Nik Arsyad and Ho, Shiaw Hooi and Lau, Peng Choong and Mahadeva, Sanjiv (2022) Efficacy and safety of per-oral endoscopic myotomy for the treatment of achalasia cardia in Malaysia: a single centre study. In: GUT 2022, Kuala Lumpur convention centre. (Unpublished)

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Abstract

INTRODUCTION: Peroral Endoscopic Myotomy (POEM), introduced in 2010, has become a widely accepted treatment for achalasia cardia. However, POEM procedure is technically challenging and recommended to be performed by experienced endoscopists. Our objective was to assess the efficacy and safety of POEM procedures performed in a tertiary referral centre. METHODOLOGY: This is a retrospective single-centre study. All consecutive achalasia patients that underwent POEM procedure (posterior approach) from November 2015 to June 2022 were recruited. Demographic data, achalasia type, technical success, procedure duration, myotomy length, duration of hospital stay, clinical success and adverse events were recorded. Technical success was defined as completion of POEM procedure from mucosa incision, to tunnel creation followed by myotomy and finally, mucosal closure. Clinical success was defined as a post-procedure Eckardt score ≤3, or a reduction of 4 or more points at 2 months or more after a successful procedure. All POEM procedures were performed by 3 endoscopists (2 gastroenterologists and 1 surgeon) who have had experience in ESD or Heller’s myotomy. RESULT: A total of 86 patients were recruited. The detailed results are summarised in Table 1. CONCLUSION: The high efficacy (with good intermediate to long-term outcome follow up) and good safety profile of the POEM procedure for achalasia cardia in our centre are comparable with the published literature. Adverse events were generally mild, and all were managed conservatively. The improvement seen in the technical success rate after the first 20 cases is in line with mastering the POEM skill after the initial learning experience.

Item Type:	Conference or Workshop Item (Poster)
Subjects:	R Medicine > R Medicine (General)
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Internal Medicine
Depositing User:	Dr Nik Arsyad Nik Muhamad Affendi
Date Deposited:	06 Sep 2022 14:32
Last Modified:	06 Sep 2022 14:32
URI:	http://irep.iium.edu.my/id/eprint/99663

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