Peroral Endoscopic Myotomy Is Feasible and Safe in a Gastric Bypass Population
BACKGROUND: Obesity is public health problem of epidemic proportions. Esophageal dysmotility including achalasia is more commonly seen in an obese population. Standard therapy for achalasia can be complicated by hepatomegaly and a post-surgical anatomy in a pre- and post-bariatric population. Peroral endoscopic myotomy (POEM) has not been adequately studied in this population.
METHODS: A retrospective review of a prospectively collected database was completed. Patients who had undergone a Roux-en-y gastric bypass (RYGB) prior to or following a POEM were enrolled. Patient demographics, operative information and post-operative course data was collected.
RESULTS: Six patients underwent POEM prior to or after RYGB. There were no peri-operative complications with an average length of stay of 1.2 days. Five patients experienced a clinical success with excellent symptom resolution. The one failure was in the setting of type III achalasia, but did have objective evidence of lower esophageal sphincter (LES) relaxation post-operatively.
CONCLUSION: POEM in the setting of bariatric surgery is safe and feasible. The potential increase in GERD following POEM is obviated by RYGB anatomy. In an obese individual, a staged POEM prior to or following a RYGB is an appropriate treatment algorithm for obese and achalasia.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Obesity surgery - 29(2019), 11 vom: 18. Nov., Seite 3523-3526 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bashir, Umair [VerfasserIn] |
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| Anmerkungen: |
Date Completed 26.05.2020 Date Revised 09.01.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1007/s11695-019-04026-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM298312050 |
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| 245 | 1 | 0 | |a Peroral Endoscopic Myotomy Is Feasible and Safe in a Gastric Bypass Population |
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| 500 | |a Date Completed 26.05.2020 | ||
| 500 | |a Date Revised 09.01.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Obesity is public health problem of epidemic proportions. Esophageal dysmotility including achalasia is more commonly seen in an obese population. Standard therapy for achalasia can be complicated by hepatomegaly and a post-surgical anatomy in a pre- and post-bariatric population. Peroral endoscopic myotomy (POEM) has not been adequately studied in this population | ||
| 520 | |a METHODS: A retrospective review of a prospectively collected database was completed. Patients who had undergone a Roux-en-y gastric bypass (RYGB) prior to or following a POEM were enrolled. Patient demographics, operative information and post-operative course data was collected | ||
| 520 | |a RESULTS: Six patients underwent POEM prior to or after RYGB. There were no peri-operative complications with an average length of stay of 1.2 days. Five patients experienced a clinical success with excellent symptom resolution. The one failure was in the setting of type III achalasia, but did have objective evidence of lower esophageal sphincter (LES) relaxation post-operatively | ||
| 520 | |a CONCLUSION: POEM in the setting of bariatric surgery is safe and feasible. The potential increase in GERD following POEM is obviated by RYGB anatomy. In an obese individual, a staged POEM prior to or following a RYGB is an appropriate treatment algorithm for obese and achalasia | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Achalasia | |
| 650 | 4 | |a Bariatric surgery | |
| 650 | 4 | |a POEM | |
| 700 | 1 | |a El Abiad, Rami |e verfasserin |4 aut | |
| 700 | 1 | |a Gerke, Henning |e verfasserin |4 aut | |
| 700 | 1 | |a Keech, John |e verfasserin |4 aut | |
| 700 | 1 | |a Parekh, Kalpaj |e verfasserin |4 aut | |
| 700 | 1 | |a Nau, Peter |e verfasserin |4 aut | |
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