Peroral endoscopic myotomy in the endoscopy unit: location, location, location

Pannu, Davinderbir; White, Jeffrey D.; Draganov, Peter V.

doi:10.1016/j.gie.2015.08.011

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…It has been proposed that POEM may be associated with cost savings considering its less invasive nature, which translates into shorter procedural times and easier post-procedural care. In addition, POEM is typically performed in the endoscopy unit[11819] rather than operating theater, with the latter entailing higher charges. However, it must be acknowledged that RHM is performed with a fundoplication as opposed to POEM which does not.…”

Section: Discussionmentioning

confidence: 99%

Peroral endoscopic myotomy achieves similar clinical response but incurs lesser charges compared to robotic heller myotomy

Khashab

Kumbhari

Tieu

et al. 2017

Saudi J Gastroenterol

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Section: Discussionmentioning

confidence: 99%

Peroral endoscopic myotomy achieves similar clinical response but incurs lesser charges compared to robotic heller myotomy

Khashab

Kumbhari

Tieu

et al. 2017

Saudi J Gastroenterol

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“…However, some conditions must be met. Pannu et al [48] suggested that preparation of the following before performing POEM in an endoscopic unit is essential: (1) stateof- the-art facilities, (2) general anesthesia equipment in the endoscopy unit, (3) full anesthesia support team with protocol of anesthesia for POEM, (4) Considering surgical back-up. On the other hand, no anesthetic guidelines have been established for POEM and anesthetic management is inadequate.…”

Section: Future Of Anesthetic Management For Poemmentioning

confidence: 99%

Anesthetic Consideration for Peroral Endoscopic Myotomy

Bang

Park

2019

Clin Endosc

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A recent achalasia guideline suggests that peroral endoscopic myotomy (POEM) is a safe option for achalasia that is as effective as Heller myotomy. It is recommended that POEM should be performed under general anesthesia. The incidence of adverse events such as bleeding, perforation, and carbon dioxide insufflation-related complications was lower in POEM under endotracheal general anesthesia than in POEM under sedation. Subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumoperitoneum, and accompanying hemodynamic instability can be caused by carbon dioxide insufflation. Treatment of possible physiological changes and adverse events during the POEM procedure from the point of view of anesthesiologists may give endoscopists a new perspective on improving patient safety. The territory of therapeutic endoscopy can be expanded through cooperation with other departments, including anesthesia services. Efforts to understand different perspectives will certainly help not only secure patient safety but also expand the area of treatment.

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