Early esophagram in per-oral endoscopic myotomy (POEM) for XXXX does not predict long-term outcomes.

@entity1 @entity773 @entity1318
BACKGROUND: In the recently reported international survey of centers performing per-oral endoscopic myotomy (POEM), 88% of operators reported obtaining routinely an early postoperative contrast esophagram. To date, there have been no studies to assess the prognostic value of early esophagram in POEM. METHODS: A retrospective review of a prospectively maintained, single-institution database of @entity1 who underwent POEM for treatment of @entity1318 was conducted. @entity1 were evaluated with a routine contrast esophagram on the first postoperative day ( @entity773 ) to assess for perforation. The finding of delayed esophageal emptying, as determined by an attending radiologist, was compared with the @entity1 ' symptomatic outcomes and functional parameters at one year follow-up. RESULTS: Contrast esophagram was obtained on @entity773 for 72 @entity1 undergoing POEM; 26 @entity1 (36%) were observed to have a delay in esophageal emptying. Both groups of @entity1 , those with a delay and those without a delay in esophageal emptying on @entity773 , had similar preoperative Eckardt scores (7      2 vs 7      2, P = ns) and column height at 5  minutes on preoperative timed barium esophagram (12.1      8  cm vs 14.1      8  cm, P  =  ns). At a mean follow-up of 1  year, there was no difference in Eckardt scores between @entity1 with and those without a delay in emptying on @entity773 esophagram (1      2 vs 1      1, P = ns), nor was there a difference between the 2 groups in column height at 5  minutes on TBE (5.5      5  cm for delay vs 4.2      4  cm for no delay; P = ns). Rates of treatment failure, as measured by Eckardt score >3 or need for subsequent treatment, also did not differ between the 2 groups (3 @entity1 with delay vs 4 @entity1 without delay in emptying, P = ns). CONCLUSION: Delay in passage of contrast on @entity773 esophagram did not predict symptomatic or physiologic outcomes at 1-year follow-up in @entity1 undergoing POEM for treatment of @entity1318 .
