Outcomes of Peroral Endoscopic Myotomy (POEM) for Treatment of Achalasia in Elderly Patients: A Single Institution Retrospective Cohort Study
Konstantinos P. Economopoulos, Deanna L. Palenzuela Rothman, Elan Witkowski, Charudutt Paranjape, Kumar KrishnanBackground:
POEM has been shown to have excellent safety and efficacy in adults. We report our experience with the POEM for the treatment of achalasia in elderly patients (65 y or older).
Methods:
This is a single-institution retrospective cohort study over a span of 4 years. The primary outcome was clinical success, defined as improvement in dysphagia score to ≤1 without need for a reintervention in the first 6 months. Secondary outcomes included technical success, rate of reintervention, and postprocedural complications.
Results:
A total of 51 patients (male 52.9%, mean age: 72.9±6.2 y; range 65 to 91 y) underwent POEM for treatment of achalasia. Most patients [n=27 (52.9%)] had achalasia type II, while 13 (25.5%) had achalasia type I and 11 (21.6%) had achalasia type III. Technical success was achieved in 100% of patients (n=51), and clinical success was achieved in 96.1% of patients (n=49). The median dysphagia score improved significantly from 3 (IQR=1 to 3) preprocedure to 0 (IQR=0 to 0) at the most recent follow-up (
Conclusion:
POEM is a safe, effective, and durable treatment for all types of achalasia in elderly patients.