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

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 POE...

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Main Authors: Nik Muhamad Affendi, Nik Arsyad, Ho, Shiaw Hooi, Lau, Peng Choong, Mahadeva, Sanjiv
Format: Conference or Workshop Item
Language:English
Published: 2022
Subjects:
R Medicine (General)
Online Access:http://irep.iium.edu.my/99663/2/99663_EFFICACY%20AND%20SAFETY%20OF%20PER-ORAL%20ENDOSCOPIC%20MYOTOMY.pdf
http://irep.iium.edu.my/99663/
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spelling my.iium.irep.996632022-09-06T06:32:52Z http://irep.iium.edu.my/99663/ 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 Ho, Shiaw Hooi Lau, Peng Choong Mahadeva, Sanjiv R Medicine (General) 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. 2022-08-19 Conference or Workshop Item PeerReviewed application/pdf en http://irep.iium.edu.my/99663/2/99663_EFFICACY%20AND%20SAFETY%20OF%20PER-ORAL%20ENDOSCOPIC%20MYOTOMY.pdf 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)
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
topic R Medicine (General)
spellingShingle R Medicine (General)
Nik Muhamad Affendi, Nik Arsyad
Ho, Shiaw Hooi
Lau, Peng Choong
Mahadeva, Sanjiv
Efficacy and safety of per-oral endoscopic myotomy for the treatment of achalasia cardia in Malaysia: a single centre study
description 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.
format Conference or Workshop Item
author Nik Muhamad Affendi, Nik Arsyad
Ho, Shiaw Hooi
Lau, Peng Choong
Mahadeva, Sanjiv
author_facet Nik Muhamad Affendi, Nik Arsyad
Ho, Shiaw Hooi
Lau, Peng Choong
Mahadeva, Sanjiv
author_sort Nik Muhamad Affendi, Nik Arsyad
title Efficacy and safety of per-oral endoscopic myotomy for the treatment of achalasia cardia in Malaysia: a single centre study
title_short Efficacy and safety of per-oral endoscopic myotomy for the treatment of achalasia cardia in Malaysia: a single centre study
title_full Efficacy and safety of per-oral endoscopic myotomy for the treatment of achalasia cardia in Malaysia: a single centre study
title_fullStr Efficacy and safety of per-oral endoscopic myotomy for the treatment of achalasia cardia in Malaysia: a single centre study
title_full_unstemmed Efficacy and safety of per-oral endoscopic myotomy for the treatment of achalasia cardia in Malaysia: a single centre study
title_sort efficacy and safety of per-oral endoscopic myotomy for the treatment of achalasia cardia in malaysia: a single centre study
publishDate 2022
url http://irep.iium.edu.my/99663/2/99663_EFFICACY%20AND%20SAFETY%20OF%20PER-ORAL%20ENDOSCOPIC%20MYOTOMY.pdf
http://irep.iium.edu.my/99663/
_version_ 1744353523021119488
score 13.211869

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