Intraprocedural fluoroscopy to determine the extent of the cardiomyotomy during per-oral endoscopic myotomy (with video) - 01/06/16
Abstract |
Background |
An adequate myotomy on the gastric side is considered essential to optimize outcomes in patients undergoing per-oral endoscopic myotomy (POEM). An objective method to measure the length of gastric myotomy has not yet been reported.
Objective |
To evaluate a new method of precisely determining the length of the submucosal tunnel below the esophagogastric junction (EGJ) using intraprocedural fluoroscopy.
Design |
Single-center cohort study.
Setting |
Academic tertiary care center.
Patients |
Twenty-four consecutive patients who underwent POEM for management of achalasia.
Interventions |
A radiopaque marker (endoscopic clip placed at the EGJ or fluoroscopically guided placement of a 19-gauge needle on the skin) was used to mark the EGJ. The endoscope was inserted to the most distal aspect of the submucosal tunnel and, using fluoroscopy, the distance between the radiopaque marker and the tip of the endoscope was measured.
Main Outcome Measurements |
Technical success, procedural impact, duration of technique, and adverse events.
Results |
Technical success was achieved in 100% of patients. The submucosal tunnel was extended in 5 patients (20.8%) with a mean extension of 1.4 ± .5 cm. The mean increase in procedure time was 4 minutes with the endoscopic clip and 2 minutes with the 19-gauge needle. There were no adverse events associated with this technique.
Limitations |
Need for fluoroscopy. Absence of available criterion standard.
Conclusions |
Intraprocedural fluoroscopy was an efficient and safe method of objectively documenting the extent of gastric myotomy during POEM. This may benefit those investigating the anatomic and physiologic changes that occur during the myotomy and those early in their experience performing POEM.
Le texte complet de cet article est disponible en PDF.Abbreviations : EGJ, LES, POEM
Plan
| DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: P. Saxena: Consultant for Boston Scientific; A. Kalloo: Founding member, equity holder, and consultant for Apollo Endosurgery; M. A. Khashab: Consultant for Boston Scientific and Olympus America. All other authors disclosed no financial relationships relevant to this publication. |
|
| If you would like to chat with an author of this article, you may contact Dr Kumbhari at vkumbhari@gmail.com. |
Vol 81 - N° 6
P. 1451-1456 - juin 2015 Retour au numéro
Article précédent
- Female authorship in major academic gastroenterology journals: a look over 20 years
- Michelle T. Long, Ania Leszczynski, Katherine D. Thompson, Sharmeel K. Wasan, Audrey H. Calderwood
- Fluorescence cytology with 5-aminolevulinic acid in EUS-guided FNA as a method for differentiating between malignant and benign lesions (with video)
- Tsukasa Ikeura, Makoto Takaoka, Kazushige Uchida, Masaaki Shimatani, Hideaki Miyoshi, Kota Kato, Chisato Ohe, Yoshiko Uemura, Masaki Kaibori, A-Hon Kwon, Kazuichi Okazaki
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?