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Objectives: We present an update on the (peroral endoscopic myotomy (POEM) difficulty score [PDS] by introducing a novel knife with waterjet functionality.
Methods: This is a retrospective review of patients who underwent POEM between May 2018 and July 2023 at the Kingston Health Sciences Center. Demographic and procedural variables were compared using descriptive and inferential statistics.
Peroral Endoscopic myotomy (POEM) in pediatric achalasia: a retrospective cohort on institutional experience and quality of life.
Orphanet J Rare Dis
January 2025
Department of Pediatric Gastroenterology and Nutrition, Amsterdam UMC, Emma Children's Hospital, Vrije Universiteit, Amsterdam, The Netherlands.
Background: Achalasia is a rare esophageal motility disorder with an estimated annual incidence of 1-5/100.000 and a mean age at diagnosis > 50 years of age. Only a fraction of the patients has an onset during childhood (estimated incidence of 0.
View Article and Find Full Text PDFElective Sternotomy With Fluoroscopic Guidance for the Removal of a Residual Implantable Cardioverter Defibrillator Lead: A Case Report and Literature Review.
Cureus
January 2025
Anesthesiology and Reanimation, Military Hospital of Avicenne, Marrakech, MAR.
Infectious myocarditis (IM) and infective endocarditis (IE), sometimes associated with infection of the surrounding mediastinal tissue or embolic complications caused by residual implantable cardioverter defibrillator (ICD) lead material embedded in the ventricle, present a significant challenge for cardiac surgeons due to the difficulty of precisely locating the old intracardiac pacing lead remnants because of the heart's continuous movement. We present the case of successful two-stage elective sternotomy extraction of two residual defibrillator leads, one trapped in the left innominate vein, easily removed after veinotomy without cardiopulmonary bypass (CPB), and the other embedded intramyocardially in the inferior wall of the right ventricle, successfully removed under CPB after fluoroscopic guidance. The patient was discharged four weeks post-operation without complications.
View Article and Find Full Text PDFThe Use of Knives With Versus Without Integrated Water-jet Function During Peroral Endoscopic Myotomy for Patients With Achalasia: A Meta-analysis.
Surg Laparosc Endosc Percutan Tech
January 2025
Department of Surgery, Division of Gastrointestinal Surgery, University of South Florida Morsani College of Medicine, Tampa, FL.
Background: Peroral endoscopic myotomy (POEM) is a well-established endoscopic treatment for achalasia, utilizing an endoscopic knife for dissection. Recently, new knives with an integrated water-jet (WJ) function have been introduced. This study aims to compare the technical, perioperative, and late postoperative outcomes between WJ knives and conventional (C) knives, which lack the WJ function, through a pairwise meta-analysis of published comparative studies.
View Article and Find Full Text PDFPosterior Peroral Endoscopic Myotomy With Versus Without Sparing of the Oblique/Sling Fibers: A Meta-analysis.
Surg Laparosc Endosc Percutan Tech
January 2025
Department of Surgery, Division of Gastrointestinal Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL.
Background And Aims: Several studies have hypothesized that sparing the oblique/sling fibers during posterior peroral endoscopic myotomy (POEM) may reduce the incidence of gastroesophageal reflux disease (GERD) and reflux esophagitis without compromising the established safety and efficacy of the procedure. This study compares perioperative, postoperative motility-related, and postoperative GERD-related outcomes between posterior oblique/sling fibers-sparing POEM (OFS-POEM) and conventional posterior POEM through a pairwise meta-analysis of comparative studies.
Methods: We conducted a systematic literature review following PRISMA guidelines to identify articles directly comparing posterior OFS-POEM with conventional posterior POEM.
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