PMID- 34466362
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  - Rethinking the need for overnight admission after peroral endoscopic myotomy 
      (POEM): a pandemic-driven approach to the future.
PG  - E1381-E1385
LID - 10.1055/a-1490-9385 [doi]
AB  - Background and study aims  COVID-19 has significantly impacted endoscopic 
      assessment and management of multiple conditions. Our group recommenced treatment 
      of highly symptomatic achalasia patients (Eckardt score >/= 6) adopting a same-day 
      discharge (SDD) algorithm and present early outcomes of its utilization. Patients 
      and methods  We enrolled all outpatients undergoing POEM at a single tertiary 
      referral center. Patients qualified for SDD if all of the following a priori 
      criteria were met: 1) ASA grade I-III; 2) No intraprocedural adverse events 
      (AEs); 3) Secure mucosal closure; 4) Post-procedure pain/nausea responsive to 
      oral medications; and 5) Patients tolerating clear fluids. Results  In 17 
      potential SDD candidates (female 82.4 %, median age 51 years [IQR 48-64]) 
      undergoing POEM, SDD was achieved in 14 (82.4 %). The remaining were admitted due 
      to post-procedure pain/nausea (n = 2) and intraprocedural concerns 
      (capnoperitoneum requiring needle decompression, n = 1). There were no 
      post-procedure AEs or unexpected readmissions. Conclusions  This study 
      demonstrates the safety and feasibility of a SDD algorithm for POEM patients and 
      challenges the necessity of routine post-POEM hospital admission. Critically 
      important during the COVID-19 pandemic, this may in fact constitute a changing 
      standard for POEM post-procedure care.
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 - Zhang, Linda Y
AU  - Zhang LY
AD  - Johns Hopkins Medical Institutions, Baltimore, Maryland, United States.
FAU - Bejjani, Michael
AU  - Bejjani M
AD  - Johns Hopkins Medical Institutions, Baltimore, Maryland, United States.
FAU - Ghandour, Bachir
AU  - Ghandour B
AD  - Johns Hopkins Medical Institutions, Baltimore, Maryland, United States.
FAU - Khashab, Mouen A
AU  - Khashab MA
AD  - Johns Hopkins Medical Institutions, Baltimore, Maryland, United States.
LA  - eng
PT  - Journal Article
DEP - 20210816
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC8367444
COIS- Competing interests Dr. Khashab is a consultant for Boston Scientific, Olympus 
      America, Medtronic and GI Supply.
EDAT- 2021/09/02 06:00
MHDA- 2021/09/02 06:01
PMCR- 2021/08/01
CRDT- 2021/09/01 07:24
PHST- 2021/02/05 00:00 [received]
PHST- 2021/03/31 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-1490-9385 [doi]
PST - epublish
SO  - Endosc Int Open. 2021 Aug 16;9(9):E1381-E1385. doi: 10.1055/a-1490-9385. 
      eCollection 2021 Sep.