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논문 기본 정보

자료유형
학술저널
저자정보
Michel Kahaleh (Robert Wood Johnson University Hospital New Brunswick NJ USA) Amy Tyberg (Robert Wood Johnson University Hospital New Brunswick NJ USA) Supriya Suresh (Weill Cornell Medical College New York NY USA) Arnon Lambroza (Weill Cornell Medical College New York NY USA) Fernando Rodriguez Casas (La Policia Bogota Colombia) Mario Rey (La Policia Bogota Colombia) Jose Nieto (Borland-Groover Jacksonville FL USA) Guadalupe Ma Martínez (Juarez Hospital Mexico City Mexico) Felipe Zamarripa (Juarez Hospital Mexico City Mexico) Vitor Arantes (Belo Horizonte Hospital Belo Horizonte Brazil) Maria G Porfilio (Hospital Escuela Dr. Ramon Madariaga Posadas Argentina) Monica Gaidhane (Robert Wood Johnson University Hospital New Brunswick NJ USA) Pietro Familiari (Gemelli University Hospital Roma Italy) Juan Carlos Carames (Santander Hospital Reynosa Mexico) Romulo Vargas-Rubio (San Ignacio University Hospital Bogota Columbia) Raul Canadas (San Ignacio University Hospital Bogota Columbia) Albis Hani (San Ignacio University Hospital Bogota Columbia) Guillermo Munoz (Robert Wood Johnson University Hospital New Brunswick NJ USA) Bismarck Castillo (Gastromedica Clinic Managua Nicaragua) Eduardo T Moura (Gastrointestinal Endoscopy Unit University of Sao Paulo Sao Paulo Brazil) Farias F Galileu (Gastrointestinal Endoscopy Unit University of Sao Paulo Sao Paulo Brazil) Hannah P Lukashok (Instituto Ecuatoriano de Enfermedades Digestivas Guayaquil Ecuador) Carlos Robles-Medranda (Instituto Ecuatoriano de Enfermedades Digestivas Guayaquil Ecuador) Eduardo G de Moura (Gastrointestinal Endoscopy Unit University of Sao Paulo Sao Paulo Brazil)
저널정보
대한소화기내시경학회 Clinical Endoscopy Clinical Endoscopy 제54권 제5호
발행연도
2021.9
수록면
701 - 705 (5page)
DOI
10.5946/ce.2020.290

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Background/Aims: Peroral endoscopic myotomy (POEM) has been increasingly used for achalasia in Latin America, where Chagasdisease is prevalent, and this makes POEM more challenging. The aim of this study was to determine the learning curve for POEMin Latin America. Methods: Patients undergoing POEM in Latin America with a single operator were included from a prospective registry over 4 years. Non-linear regression and cumulative sum control chart (CUSUM) analyses were conducted for the learning curve. Results: A total of 125 patients were included (52% male; mean age, 59 years), of which 80 had type II achalasia (64%), and 38 hadChagas disease (30%). The average pre-procedure and post-procedure Eckardt scores were 6.79 and 1.87, respectively. Technicalsuccess was achieved in 93.5% of patients, and clinical success was achieved in 88.8%. Adverse events occurred in 27 patients (22%)and included bleeding (4 patients), pneumothorax (4 patients), mucosal perforation (13 patients), mediastinitis (2 patients), andleakage (4 patients). The CUSUM chart showed a median procedure time of 97 min (range, 45-196 min), which was achieved at the 61st procedure. Procedure duration progressively decreased, with the last 10 procedures under 50 min approaching a plateau (p-value <0.01). Conclusions: Mastering POEM in Latin America requires approximately 61 procedures for both POEM efficiency and to accomplishthe procedure within 97 minutes.

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