Early clinical experience with the POEM procedure for XXXX .

@entity1318 @entity1 @entity532
BACKGROUND: Per oral endoscopic myotomy (POEM) is a viable alternative to standard Heller myotomy for surgical treatment of @entity1318 . Outcomes from the United States, Europe and Asia have been reported. We sought to report data after the initiation of POEM in a Canadian centre. METHODS: We enrolled @entity1 with @entity1318 in a research ethics board-approved pilot study. Surgeons learned the POEM procedure in a systematic manner that included visiting experts in POEM, practice in an animal laboratory and mentoring from POEM experts. Preoperative evaluation included manometry, 24-hour pH, barium swallow, endoscopy and Eckhardt Symptom Score. All @entity1 underwent gastrograffin swallow on postoperative day 1. @entity1 were re-evaluated using the Eckhardt score on postoperative day 14. RESULTS: Ten @entity1 underwent POEM. Seven @entity1 had previous endoscopic treatments: 6 had balloon dilatation and 1 had botulinum toxin injection. Mean preoperative Eckhardt score was 8.1    2.4. Mean preoperative lower esophageal sphincter resting and residual pressure was 32.3    9.2 and 20.8    5.3, respectively. Mean duration of surgery was 141.3    43.7 minutes. Mean length of hospital stay was 1 day. No major perioperative @entity532 occurred. On postoperative day 14, the mean Eckhardt score was 1    1.2. CONCLUSION: Our approach to POEM introduction was systematic and deliberate. The procedure is safe, feasible and has good perioperative outcomes. Our early results are consistent with current literature.
