Gentamicin submucosal lavage during peroral endoscopic myotomy (POEM): a retrospective analysis

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10375394" target="_blank" >RIV/00216208:11110/18:10375394 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/61988987:17110/17:A1801NHB RIV/00216208:11130/18:10375394 RIV/00023001:_____/18:00076542

Výsledek na webu

<a href="https://doi.org/10.1007/s00464-017-5677-8" target="_blank" >https://doi.org/10.1007/s00464-017-5677-8</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00464-017-5677-8" target="_blank" >10.1007/s00464-017-5677-8</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Gentamicin submucosal lavage during peroral endoscopic myotomy (POEM): a retrospective analysis

Popis výsledku v původním jazyce

Peroral endoscopic myotomy (POEM) is an evolving therapeutic modality for achalasia. According to the original Inoue&apos;s technique, a submucosal lavage with gentamicin has been practiced due to the fear of infection. This single-tertiary center study was intended to assess the clinical significance of the topical antibiotic lavage during POEM. A retrospective analysis of prospectively collected data was conducted. The outcomes of patients who received the gentamicin lavage (group A) during POEM were compared to those who did not (group B). The main outcome variables were infectious adverse events, post-POEM fever, and markers of systemic inflammatory response. One day before and after POEM, all patients received systemic antibiotic prophylaxis with ceftriaxone. Of 124 consecutive patients having undergone POEM, 60 patients received a lavage with 80 mg of gentamicin into the submucosal tunnel before starting the myotomy, while 64 patients did not. The overall treatment success at 3 months did not differ between the two groups (group A 94.7 vs. 97.5% group B). We did not experience any significant infectious adverse events in either group. CRP and WBC levels were lower in patients with lavage versus those without [CRP: median 52.7 (IQR 34.9) vs. 69.5 (54.1); p = 0.01; WBCs: median 10.9 (IQR 3.3) vs. 12.6 (3.9); p &lt; 0.01]. Post-procedural fever was present in 10% of patients in either group. During POEM, the submucosal lavage with gentamicin prior to the myotomy does not play a role in the prevention of clinically significant infectious adverse events, although the systemic inflammatory response may be decreased.

Název v anglickém jazyce

Gentamicin submucosal lavage during peroral endoscopic myotomy (POEM): a retrospective analysis

Popis výsledku anglicky

Peroral endoscopic myotomy (POEM) is an evolving therapeutic modality for achalasia. According to the original Inoue&apos;s technique, a submucosal lavage with gentamicin has been practiced due to the fear of infection. This single-tertiary center study was intended to assess the clinical significance of the topical antibiotic lavage during POEM. A retrospective analysis of prospectively collected data was conducted. The outcomes of patients who received the gentamicin lavage (group A) during POEM were compared to those who did not (group B). The main outcome variables were infectious adverse events, post-POEM fever, and markers of systemic inflammatory response. One day before and after POEM, all patients received systemic antibiotic prophylaxis with ceftriaxone. Of 124 consecutive patients having undergone POEM, 60 patients received a lavage with 80 mg of gentamicin into the submucosal tunnel before starting the myotomy, while 64 patients did not. The overall treatment success at 3 months did not differ between the two groups (group A 94.7 vs. 97.5% group B). We did not experience any significant infectious adverse events in either group. CRP and WBC levels were lower in patients with lavage versus those without [CRP: median 52.7 (IQR 34.9) vs. 69.5 (54.1); p = 0.01; WBCs: median 10.9 (IQR 3.3) vs. 12.6 (3.9); p &lt; 0.01]. Post-procedural fever was present in 10% of patients in either group. During POEM, the submucosal lavage with gentamicin prior to the myotomy does not play a role in the prevention of clinically significant infectious adverse events, although the systemic inflammatory response may be decreased.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30212 - Surgery

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Surgical Endoscopy

ISSN

0930-2794

e-ISSN

—

Svazek periodika

32

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

7

Strana od-do

300-306

Kód UT WoS článku

000422854700036

EID výsledku v databázi Scopus

2-s2.0-85021275658