Feasibility of using an led-probe in third-space endoscopy: a clinical study

Autor: Luis Fernando García Contreras, Raúl Antonio Zamarripa Mottú, Omar M. Solorzano Pineda, Raul Alberto Gutiérrez Aguilar, Oscar V. Hernández Mondragón
Rok vydání: 2020
Předmět:
Adult
Male
Myotomy
medicine.medical_specialty
medicine.medical_treatment
Scintigraphy
Third-space endoscopy
Tertiary Care Centers
03 medical and health sciences
0302 clinical medicine
Pyloromyotomy
Interquartile range
Internal medicine
medicine
Humans
Peroral endoscopic myotomy
Endoscopy
Digestive System
Prospective Studies
lcsh:RC799-869
Adverse effect
Prospective cohort study
Mexico
Lighting
Mouth
LED-probe
medicine.diagnostic_test
Gastric emptying
business.industry
Gastric peroral endoscopic myotomy
Gastroenterology
General Medicine
Middle Aged
Hepatology
Surgery
Endoscopy
Esophageal Achalasia
Treatment Outcome
Technical Advance
030220 oncology & carcinogenesis
Feasibility Studies
lcsh:Diseases of the digestive system. Gastroenterology
Female
030211 gastroenterology & hepatology
business
Zdroj: BMC Gastroenterology
BMC Gastroenterology, Vol 20, Iss 1, Pp 1-10 (2020)
ISSN: 1471-230X
DOI: 10.1186/s12876-020-01260-9
Popis: Background Third-space endoscopy is a novel, safe, and effective method for treating different gastrointestinal conditions. However, several failed endoscopic procedures are attributed to incomplete myotomy. Lighting devices are used to prevent organic injuries. We aimed to investigate the feasibility of using a hand-made LED-probe (LP) in third-space procedures. Methods This prospective study was conducted in a tertiary-care center in Mexico between December 2016 and January 2019. We included peroral endoscopic myotomy (POEM) and gastric peroral endoscopic myotomy(G-POEM) procedures. Pseudoachalasia, peptic ulcer, normal gastric emptying scintigraphy (GES) and prepyloric tumors were excluded. LP was used to guide or confirm procedures. Clinical and procedural characteristics were recorded and analyzed. Results Seventy third-space procedures were included (42POEM,28G-POEM), with an average patient age of 46.7 ± 14.3 and 43.7 ± 10.1 years, respectively. For the POEM and G-POEM groups, respectively, 18/42(42.9%) and 13/28(46.7%) patients were males; median procedure times were 50 (interquartile range [IQR]: 38–71) and 60(IQR: 48–77) min, median LP placement times were 5(IQR: 4-6) and 6(IQR: 5-7) min, mild adverse events occurred in 4(9.4%) and 4(14.2%) of cases, and clinical success at 6 months occurred in 100 and 85.7% of cases. Integrated relaxation pressure (IRP) improved from 27.3 ± 10.8 to 9.5 ± 4.1 mmHg (p Conclusions Using an LP is promising and allows guiding during third-space procedures either for submucosal tunnel creation or myotomy confirmation, with excellent safety and efficacy in clinical practice.
Databáze: OpenAIRE
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