Establishment of a per oral endoscopic myotomy program at a rural tertiary care center

Abstract Background and study aims The aim of this study was to assess long-term clinical outcomes beyond 6 years in patients who underwent per-oral endoscopic myotomy (POEM) for the treatment of achalasia. Patients and methods Patients with achalasia who underwent POEM between 2010 and 2012 and had follow-up of at least 6 years were retrospectively identified at eight tertiary care centers. The primary outcome evaluated was clinical success defined by an Eckardt symptom score (ESS) ≤ 3 for the duration of the follow-up period. The clinical success cohort was compared to failure (ESS > 3 at any time during follow-up) in order to identify characteristics associated with symptom relapse. The incidence of patient-reported gastroesophageal reflux (GER) was also evaluated. Results Seventy-three patients with 6-year follow-up data were identified. Sustained clinical remission was noted in 89 % (65/73) at 6-years. Mean ESS decreased from 7.1 ± 2.3 pre-procedure to 1.1 ± 1.1 at 6 years (P < 0.001). Symptomatic reflux was reported by 27 of 72 patients (37.5 %). Type I achalasia (OR 10.8, P = 0.04) was found to be associated with clinical failure on logistic regression analysis. Conclusions In patients with achalasia, POEM provides high initial clinical success with excellent long-term outcomes. There are high rates of patient-reported gastroesophageal reflux post-procedure which persist at long-term follow-up.

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Peroral endoscopic myotomy for the treatment of achalasia and other esophageal motor disorders: Short-term and medium-term results at a Mexican tertiary care center

Revista de Gastroenterología de México (English Edition) ◽

10.1016/j.rgmxen.2018.04.004 ◽

2019 ◽

Vol 84 (1) ◽

pp. 1-10

Author(s):

O.V. Hernández-Mondragón ◽

O.M. Solórzano-Pineda ◽

M.A. González-Martínez ◽

J.M. Blancas-Valencia ◽

C. Caballero-Luengas

Keyword(s):

Care Center ◽

Tertiary Care ◽

Peroral Endoscopic Myotomy ◽

Motor Disorders ◽

Tertiary Care Center ◽

Medium Term ◽

Short Term ◽

Esophageal Motor Disorders ◽

Endoscopic Myotomy

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P.1.352: LEARNING CURVE ASSOCIATED WITH PER-ORAL SINGLE BALLOON ENTEROSCOPY: RESULTS OF A TERTIARY CARE CENTER

Digestive and Liver Disease ◽

10.1016/s1590-8658(11)60580-x ◽

2011 ◽

Vol 43 ◽

pp. S264

Author(s):

C. Barbera ◽

M. Manno ◽

F. Pigò ◽

A. Caruso ◽

H. Bertani ◽

...

Keyword(s):

Learning Curve ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Balloon Enteroscopy ◽

Single Balloon ◽

Single Balloon Enteroscopy ◽

Per Oral

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Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi

International Journal of Chronic Diseases ◽

10.1155/2014/413071 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Aysha Almas ◽

Ayaz Ghouse ◽

Ahmed Raza Iftikhar ◽

Munawwar Khursheed

Keyword(s):

Calcium Channel ◽

Calcium Channel Blocker ◽

Channel Blocker ◽

Care Center ◽

Tertiary Care ◽

Hypertensive Crisis ◽

Uncontrolled Hypertension ◽

Tertiary Care Center ◽

Oral Calcium ◽

Per Oral

Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi.Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included.Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) were the most commonly administered medication in the ER. The mean (SD) drop in SBP in patients with hypertensive crisis on intravenous treatment was 53.1 (29) mm Hg and on per oral treatment was 43 (27) mm Hg. The maximum mean (SD) drop in blood pressure was seen by intravenous sodium nitroprusside; 80 (51) mm Hg in SBP. Acute renal failure was the most common complication with a prevalence of 11.5% (24).Conclusion. The prevalence of hypertensive crisis is high. Per oral calcium channel blocker and intravenous nitrate are the most commonly administered medications in our setup.

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