USF-LVHN SELECT
Peroral Endoscopic Myotomy; Novice Surgeon Learning Curve.
Publication/Presentation Date
6-16-2022
Abstract
INTRODUCTION: Peroral endoscopic myotomy (POEM) is a novel endoscopic procedure used to treat achalasia and other spastic esophageal disorders that is an alternative to Heller myotomy. We seek to define the learning curve of POEM for a foregut surgeon with no formal endoscopic or POEM training by analyzing different intraoperative factors in a single series.
METHODS AND PROCEDURES: The first 38 consecutive patients undergoing POEM by a single foregut surgeon were included in this retrospective study. Inverse curve regression models were used to analyze total operative time (TOT) and total operative time per centimeter of myotomy (TOT-CM), in addition to other intraoperative variables. Clinical outcomes were reported as pre- and post-operative Eckardt Scores.
RESULTS: All patients had type II achalasia with no post-operative complications observed. Eckardt scores improved postoperatively (median (range): 1 (0-4)) compared with the preoperative scores (10 (8-12)) (P < .001). The total operative time (median 76 minutes, range 51-129) decreased significantly over the course of the series (R
CONCLUSION: The number of cases for a foregut surgeon to become proficient in a POEM procedure was found to be 12-14 cases. The learning curve for a POEM in a formally trained foregut surgeon may be comparable to an endoscopically trained interventionist.
First Page
31348221109457
Last Page
31348221109457
ISSN
1555-9823
Published In/Presented At
Bach, G. H., Crowell, W., Griffith, J., Rachman, B., Bigness, A., Reddy, N., Sujka, J., Mhaskar, R., & DuCoin, C. (2022). Peroral Endoscopic Myotomy; Novice Surgeon Learning Curve. The American surgeon, 31348221109457. Advance online publication. https://doi.org/10.1177/00031348221109457
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
35710330
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article