Kara DiJoseph, DO1, Carl Manzo, MD2, Abraham Mathew, MD2
1Penn State Hershey Medical Center, Hershey, PA; 2Penn State University Milton S. Hershey Medical Center, Hershey, PA
Introduction: Achalasia is a spastic motility disease of the esophagus, characterized by aperistalsis and a nonrelaxing lower esophageal sphincter. Since this disorder impacts individual’s quality of life drastically, more treatment modalities have emerged to help relieve patients’ discomfort; the most recent palliative treatment discovered being the Peroral Endoscopic Myotomy, a non-invasive procedure to alleviate hypertonicity at with the lower esophageal sphincter. With any new procedure, there is a high risk of complications including perforations and pneumothoraces that could lead to a lengthy post-operative stay. As time goes on, we are learning that this method maybe safer than we originally thought.1,2
Methods: Utilizing the electronic medical record and with IRB approval, we analyzed 149 patients who underwent POEM procedure. Readmission rates were compared between patients who were discharged to those who were kept overnight.
Results: 149 patients underwent POEM in the study periodbetween September 23, 2013 and March 1, 2019. Same day discharge was standard in February 2017; 59 of those patients were discharged after the POEM the same day.
Discussion: POEM has been established as a very successful alternative treatment for severe achalasia that is minimally invasive compared to a surgical myotomy. It comes with many risks including pneumoperitoneum and esophageal perforation as seen in the early studies. This study effectively demonstrated the safety of same day discharge with zero people requiring readmission. In conclusion, same day discharge after a POEM is relatively safe to the general population and does not require post-operative admission for surveillance.2,3
Citation: Kara DiJoseph, DO; Carl Manzo, MD; Abraham Mathew, MD. P2390 - SAME DAY DISCHARGE AFTER PERORAL ENDOSCOPIC MYOTOMY VERSUS OVERNIGHT OBSERVATION. Program No. P2390. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.