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Learning curve for peroral endoscopic myotomy

Learning curve for peroral endoscopic myotomy ENDOSCOPY INTERNATIONAL OPEN El Zein, M., Kumbhari, V., Ngamruengphong, S., Carson, K. A., Stein, E., Tieu, A., Chaveze, Y., Ismail, A., Dhalla, S., Clarke, J., Kalloo, A., Canto, M., Khashab, M. A. 2016; 4 (5): E577–E582

Abstract

Although peroral endoscopic myotomy (POEM) is being performed more frequently, the learning curve for gastroenterologists performing the procedure has not been well studied. The aims of this study were to define the learning curve for POEM and determine which preoperative and intraoperative factors predict the time that will be taken to complete the procedure and its different steps.Consecutive patients who underwent POEM performed by a single expert gastroenterologist for the treatment of achalasia or spastic esophageal disorders were included. The POEM procedure was divided into four steps: mucosal entry, submucosal tunneling, myotomy, and closure. Nonlinear regression was used to determine the POEM learning plateau and calculate the learning rate.A total of 60 consecutive patients underwent POEM in an endoscopy suite. The median length of procedure (LOP) was 88 minutes (range 36?-?210), and the mean (± standard deviation [SD]) LOP per centimeter of myotomy was 9 ± 5 minutes. The total operative time decreased significantly as experience increased (P?

View details for DOI 10.1055/s-0042-104113

View details for Web of Science ID 000376516100015

View details for PubMedID 27227118

View details for PubMedCentralID PMC4874807