PMID- 34466359
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210903
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 9
IP  - 9
DP  - 2021 Sep
TI  - Clinical impact of routine CT esophagogram after peroral endoscopic myotomy 
      (POEM) for esophageal motility disorders.
PG  - E1355-E1360
LID - 10.1055/a-1512-9638 [doi]
AB  - Background and study aims  Per oral endoscopic myotomy (POEM) of the lower 
      esophageal sphincter has become a major treatment for esophageal motility 
      disorders, especially achalasia. POEM can result in esophageal bleeding or 
      perforation and pleural and mediastinal effusion. Early routine computed 
      tomography (CT) esophagogram is frequently performed to assess these adverse 
      events (AEs) before resuming oral food intake. We sought to evaluate the value of 
      routine CT esophagogram on postoperative day (POD) 1 after POEM. Patients and 
      methods  This single-center retrospective study was performed in a tertiary 
      referral center for interventional digestive endoscopy. We included consecutive 
      patients with POEM and routine CT esophagogram on POD 1 between July 2018 and 
      July 2019. Results  Fifty-eight patients were included in the study, 79 % of whom 
      had achalasia. Twenty patients (34 %) presented post-endoscopic AEs, including 
      two patients with severe AEs requiring intensive care admission (one compressive 
      pneumothorax and one mediastinitis); no deaths occurred. Of the 58 CT 
      esophagograms performed, only one was normal. The 57 others (98 %) showed at 
      least one abnormal finding: pneumoperitoneum or retroperitoneal air (91 %), 
      pneumomediastinum (78 %), pleural effusion (34 %), pneumothorax (14 %), pneumonia 
      (7 %), pericardial effusion (2 %), and mediastinal collection (2 %). CT 
      esophagograms revealed AEs and modified therapeutic management in eight patients 
      of 58 (14 %), all of whom had clinical symptoms prior to CT. Conclusions  POD 1 
      CT esophagogram after POEM for esophageal motility disorders diagnosed clinically 
      meaningful AEs in 14 % of patients, all associated with persistent clinical 
      symptoms. Routine use of CT esophagogram after POEM in asymptomatic patients is 
      questionable.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Chartier, Marion
AU  - Chartier M
AD  - Department of Gastroenterology and Digestive Oncology, Cochin Hospital, 
      Assistance Publique-Hopitaux de Paris, Paris, France.
FAU - Barat, Maxime
AU  - Barat M
AD  - Department of Abdominal and Interventional Imaging, Cochin Hospital, Assistance 
      Publique-Hopitaux de Paris, Paris, France.
AD  - Universite de Paris, Paris, France.
FAU - Dohan, Anthony
AU  - Dohan A
AD  - Department of Abdominal and Interventional Imaging, Cochin Hospital, Assistance 
      Publique-Hopitaux de Paris, Paris, France.
AD  - Universite de Paris, Paris, France.
FAU - Belle, Arthur
AU  - Belle A
AD  - Department of Gastroenterology and Digestive Oncology, Cochin Hospital, 
      Assistance Publique-Hopitaux de Paris, Paris, France.
FAU - Oudjit, Ammar
AU  - Oudjit A
AD  - Department of Abdominal and Interventional Imaging, Cochin Hospital, Assistance 
      Publique-Hopitaux de Paris, Paris, France.
FAU - Abou Ali, Einas
AU  - Abou Ali E
AD  - Department of Gastroenterology and Digestive Oncology, Cochin Hospital, 
      Assistance Publique-Hopitaux de Paris, Paris, France.
AD  - Universite de Paris, Paris, France.
FAU - Hallit, Rachel
AU  - Hallit R
AD  - Department of Gastroenterology and Digestive Oncology, Cochin Hospital, 
      Assistance Publique-Hopitaux de Paris, Paris, France.
FAU - Leandri, Chloe
AU  - Leandri C
AD  - Department of Gastroenterology and Digestive Oncology, Cochin Hospital, 
      Assistance Publique-Hopitaux de Paris, Paris, France.
FAU - Scialom, Sophie
AU  - Scialom S
AD  - Department of Gastroenterology and Digestive Oncology, Cochin Hospital, 
      Assistance Publique-Hopitaux de Paris, Paris, France.
FAU - Coriat, Romain
AU  - Coriat R
AD  - Department of Gastroenterology and Digestive Oncology, Cochin Hospital, 
      Assistance Publique-Hopitaux de Paris, Paris, France.
AD  - Universite de Paris, Paris, France.
FAU - Chaussade, Stanislas
AU  - Chaussade S
AD  - Department of Gastroenterology and Digestive Oncology, Cochin Hospital, 
      Assistance Publique-Hopitaux de Paris, Paris, France.
AD  - Universite de Paris, Paris, France.
FAU - Soyer, Philippe
AU  - Soyer P
AD  - Department of Abdominal and Interventional Imaging, Cochin Hospital, Assistance 
      Publique-Hopitaux de Paris, Paris, France.
AD  - Universite de Paris, Paris, France.
FAU - Barret, Maximilien
AU  - Barret M
AD  - Department of Gastroenterology and Digestive Oncology, Cochin Hospital, 
      Assistance Publique-Hopitaux de Paris, Paris, France.
AD  - Universite de Paris, Paris, France.
LA  - eng
PT  - Journal Article
DEP - 20210816
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC8367446
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2021/09/02 06:00
MHDA- 2021/09/02 06:01
PMCR- 2021/08/01
CRDT- 2021/09/01 07:24
PHST- 2021/01/14 00:00 [received]
PHST- 2021/05/10 00:00 [accepted]
PHST- 2021/09/01 07:24 [entrez]
PHST- 2021/09/02 06:00 [pubmed]
PHST- 2021/09/02 06:01 [medline]
PHST- 2021/08/01 00:00 [pmc-release]
AID - 10.1055/a-1512-9638 [doi]
PST - epublish
SO  - Endosc Int Open. 2021 Aug 16;9(9):E1355-E1360. doi: 10.1055/a-1512-9638. 
      eCollection 2021 Sep.