Gentamicin submucosal lavage during peroral endoscopic myotomy (POEM): a retrospective analysis
| Autor: | Hana Svecova, Zuzana Vackova, Julius Spicak, Jan Martinek, Julia Bayer, Petr Stirand |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Natural Orifice Endoscopic Surgery Myotomy medicine.medical_specialty medicine.medical_treatment Achalasia Gastroenterology Endoscopy Gastrointestinal Group B 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Therapeutic Irrigation Adverse effect Retrospective Studies business.industry Ceftriaxone Antibiotic Prophylaxis Middle Aged Hepatology medicine.disease Anti-Bacterial Agents Surgery Esophageal Achalasia Treatment Outcome 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Gentamicin Gentamicins business Abdominal surgery medicine.drug |
| Zdroj: | Surgical Endoscopy. 32:300-306 |
| ISSN: | 1432-2218 0930-2794 |
| Popis: | Peroral endoscopic myotomy (POEM) is an evolving therapeutic modality for achalasia. According to the original Inoue’s technique, a submucosal lavage with gentamicin has been practiced due to the fear of infection. This single-tertiary center study was intended to assess the clinical significance of the topical antibiotic lavage during POEM. A retrospective analysis of prospectively collected data was conducted. The outcomes of patients who received the gentamicin lavage (group A) during POEM were compared to those who did not (group B). The main outcome variables were infectious adverse events, post-POEM fever, and markers of systemic inflammatory response. One day before and after POEM, all patients received systemic antibiotic prophylaxis with ceftriaxone. Of 124 consecutive patients having undergone POEM, 60 patients received a lavage with 80 mg of gentamicin into the submucosal tunnel before starting the myotomy, while 64 patients did not. The overall treatment success at 3 months did not differ between the two groups (group A 94.7 vs. 97.5% group B). We did not experience any significant infectious adverse events in either group. CRP and WBC levels were lower in patients with lavage versus those without [CRP: median 52.7 (IQR 34.9) vs. 69.5 (54.1); p = 0.01; WBCs: median 10.9 (IQR 3.3) vs. 12.6 (3.9); p |
| Databáze: | OpenAIRE |
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