Poem as a Treatment Option For Achalasia In Patients 65 Years of Age and Older

Aims POEM is an effective method of treatment in patients with achalasia. The efficacy of that endoscopic intervention is comparable to Heller’s operation. Shorter operation time and length of hospital stay, as well as lower complication rate, are among the advantages of the peroral procedure. However, the usage of this operation in patients over 65 years with comorbidities is doubtful.

Methods From July 2014 to October 2020 in Moscow Clinical Scientific Center POEM was performed in 280 patients with achalasia. The were 49 patients over 65 years with a mean age of 70.6 years (65-84). Pre-operation diagnostics included high-resolution manometry, upper endoscopy and X-ray imaging. From July 2014 to October 2020 in Moscow Clinical Scientific Center POEM was performed in 280 patients with achalasia. They were 49 patients over 65 years with a mean age of 70.6 years (65-84). Pre-operation diagnostics included high-resolution manometry, upper endoscopy and X-ray imaging.

Results The mean operation time was 88.8 minutes. The average number of days at the hospital was 2.91. The results are comparable with a group of patients under 65 years old. Endoscopic control was performed 3, 6 and 12 months after surgery. In all patients, except for two cases, no complications related to POEM were encountered. None of the clinical observations showed the development of complications associated with comorbidities. One patient after the operation had clinical symptoms of reflux esophagitis, which was corrected after the appointment of PPI. Another patient had a relapse of complaints after 11 months. POEM was performed again. Although there are no symptoms for 5 months, dynamic follow-up continues.

Conclusions The patient’s age and physical status do not affect the duration or technical features of surgery. POEM has shown effectiveness and feasibility in the group of patients over 65 years and may possibly substitute established treatments of achalasia.

Citation: Kanischev I, Nedoluzhko I, Shishin K et al. eP36 POEM AS A TREATMENT OPTION FOR ACHALASIA IN PATIENTS 65 YEARS OF AGE AND OLDER. Endoscopy 2021; 53: S109.

Publication History

Article published online:
19 March 2021