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Gentamicin submucosal lavage during peroral endoscopic myotomy (POEM): a retrospective analysis
J. Bayer, Z. Vackova, H. Svecova, P. Stirand, J. Spicak, J. Martinek,
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články
NLK
ProQuest Central
od 2000-01-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 2000-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 2000-01-01 do Před 1 rokem
- MeSH
- achalázie jícnu chirurgie MeSH
- antibakteriální látky aplikace a dávkování MeSH
- antibiotická profylaxe * MeSH
- ceftriaxon aplikace a dávkování MeSH
- dospělí MeSH
- endoskopické operace přirozenými otvory metody MeSH
- gastrointestinální endoskopie metody MeSH
- gentamiciny aplikace a dávkování MeSH
- léčebná irigace metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- myotomie metody MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is an evolving therapeutic modality for achalasia. According to the original Inoue'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. METHODS: 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. RESULTS: 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 < 0.01]. Post-procedural fever was present in 10% of patients in either group. CONCLUSIONS: 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.
Citace poskytuje Crossref.org
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- $a Bayer, Julia $u Department of Hepatogastroenterology, IKEM, Videnska 1958/9, 140 21, Prague 4, Czech Republic. 2nd Faculty of Medicine, Charles University, Prague, Czech Republic.
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- $a Gentamicin submucosal lavage during peroral endoscopic myotomy (POEM): a retrospective analysis / $c J. Bayer, Z. Vackova, H. Svecova, P. Stirand, J. Spicak, J. Martinek,
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- $a BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is an evolving therapeutic modality for achalasia. According to the original Inoue'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. METHODS: 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. RESULTS: 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 < 0.01]. Post-procedural fever was present in 10% of patients in either group. CONCLUSIONS: 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.
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- $a Vackova, Zuzana $u Department of Hepatogastroenterology, IKEM, Videnska 1958/9, 140 21, Prague 4, Czech Republic.
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- $a Martinek, Jan $u Department of Hepatogastroenterology, IKEM, Videnska 1958/9, 140 21, Prague 4, Czech Republic. jan.martinek@volny.cz. 1st Faculty of Medicine, Institute of Physiology, Charles University, Prague, Czech Republic. jan.martinek@volny.cz. Faculty of Medicine, Ostrava University, Ostrava, Czech Republic. jan.martinek@volny.cz.
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