PMID- 29451180
OWN - NLM
STAT- MEDLINE
DCOM- 20181105
LR  - 20181113
IS  - 1998-4049 (Electronic)
IS  - 1319-3767 (Print)
IS  - 1319-3767 (Linking)
VI  - 24
IP  - 1
DP  - 2018 Jan-Feb
TI  - Outcome of peroral endoscopic myotomy in achalasia cardia: Experience with a new 
      triangular knife.
PG  - 18-24
LID - 10.4103/sjg.SJG_361_17 [doi]
AB  - BACKGROUND AND AIM: Peroral endoscopic myotomy (POEM) is a technically demanding 
      procedure. Recently, a new triangular knife with integrated water jet function 
      (TTJ) has been introduced. The present study was aimed to analyze and compare the 
      operating time, efficacy, and adverse events (AEs) between the conventional (TT 
      knife) and new knife (TTJ). PATIENTS AND METHODS: All patients with achalasia 
      cardia (AC) who underwent POEM between August 2015 and November 2016 were 
      analyzed retrospectively. Operating time (OT), technical success, and AEs were 
      assessed and compared between TT and TTJ knife. RESULTS: A total of 193 patients 
      with AC underwent POEM during the specified period. Both groups had equivalent 
      number of different subtypes of AC (I, II, and III). There was no difference in 
      technical success between the two groups (TT, 99% vs TT, 98.9%). OT was 
      significantly less in the TTJ group as compared to TT group (53.8 +/- 15.2 vs 66.26 
      +/- 19.2; P = 0.0001). On subanalysis, OT taken for submucosal tunneling was 
      significantly less with TTJ knife (34.6 +/- 10.1 vs 45.83 +/- 14.80), whereas OT was 
      similar for myotomy and clipping in both the groups. Significantly fewer use of 
      coagulation forceps and exchanges of accessories were required in TTJ knife group 
      (2.92 +/- 1.77 vs 10.5 +/- 3.58; P = 0.0001). There were no major AEs. Minor AEs were 
      noted in 21.5% and 31% of patients in TTJ and TT knife groups, respectively. 
      CONCLUSION: New triangular knife reduces procedure time and technical difficulty 
      with POEM. POEM is an efficacious treatment for achalasia and can be safely 
      executed in an endoscopy unit.
FAU - Nabi, Zaheer
AU  - Nabi Z
AD  - Consultant Gastroenterologist, Department of Gastroenterology, Asian Institute of 
      Gastroenterology, Hyderabad, Telangana, India.
FAU - Ramchandani, Mohan
AU  - Ramchandani M
AD  - Consultant Gastroenterologist, Department of Gastroenterology, Asian Institute of 
      Gastroenterology, Hyderabad, Telangana, India.
FAU - Chavan, Radhika
AU  - Chavan R
AD  - Consultant Gastroenterologist, Department of Gastroenterology, Asian Institute of 
      Gastroenterology, Hyderabad, Telangana, India.
FAU - Kalapala, Rakesh
AU  - Kalapala R
AD  - Consultant Gastroenterologist, Department of Gastroenterology, Asian Institute of 
      Gastroenterology, Hyderabad, Telangana, India.
FAU - Darisetty, Santosh
AU  - Darisetty S
AD  - Consultant Anaesthesiologist, Department of Gastroenterology, Asian Institute of 
      Gastroenterology, Hyderabad, Telangana, India.
FAU - Reddy, D Nageshwar
AU  - Reddy DN
AD  - Consultant Gastroenterologist, Department of Gastroenterology, Asian Institute of 
      Gastroenterology, Hyderabad, Telangana, India.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - India
TA  - Saudi J Gastroenterol
JT  - Saudi journal of gastroenterology : official journal of the Saudi 
      Gastroenterology Association
JID - 9516979
SB  - IM
CIN - Saudi J Gastroenterol. 2018 Jan-Feb;24(1):1-2. doi: 10.4103/sjg.SJG_488_17. PMID: 
      29451176
MH  - Adult
MH  - Endoscopy/*instrumentation
MH  - Esophageal Achalasia/*surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myotomy/*instrumentation
MH  - Operative Time
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC5848319
OTO - NOTNLM
OT  - Achalasia
OT  - endoscopy
OT  - peroral endoscopic myotomy
COIS- There are no conflicts of interest.
EDAT- 2018/02/17 06:00
MHDA- 2018/11/06 06:00
PMCR- 2018/01/01
CRDT- 2018/02/17 06:00
PHST- 2018/02/17 06:00 [entrez]
PHST- 2018/02/17 06:00 [pubmed]
PHST- 2018/11/06 06:00 [medline]
PHST- 2018/01/01 00:00 [pmc-release]
AID - SaudiJGastroenterol_2018_24_1_18_225391 [pii]
AID - SJG-24-18 [pii]
AID - 10.4103/sjg.SJG_361_17 [doi]
PST - ppublish
SO  - Saudi J Gastroenterol. 2018 Jan-Feb;24(1):18-24. doi: 10.4103/sjg.SJG_361_17.