ArticleClinical endoscopy2021
The Learning Curve for Peroral Endoscopic Myotomy in Latin America: A Slide to the Right?
Article in Clinical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Short versus long myotomy during peroral endoscopic myotomy for achalasia: a systematic review and meta-analysis.Annals of medicine and surgery (2012) · 2026Article
- The learning curve for peroral endoscopic myotomy in a tertiary center of China.Surgical endoscopy · 2026Article
- Management Strategies for Zenker's Diverticulum: A Comprehensive Review.Journal of clinical medicine · 2025Review
- Issues to be Considered for Learning Curve for Peroral Endoscopic Myotomy.Clinical endoscopy · 2021Article
- Diagnosis and Management of Achalasia: Updates of the Last Two Years.Journal of clinical medicine · 2021Review
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Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimsPeroral endoscopic myotomy (POEM) has been increasingly used for achalasia in Latin America, where Chagas disease is prevalent, and this makes POEM more challenging. The aim of this study was to determine the learning curve for POEM in Latin America.
methodsPatients undergoing POEM in Latin America with a single operator were included from a prospective registry over 4 years. Non-linear regression and cumulative sum control chart (CUSUM) analyses were conducted for the learning curve.
resultsA total of 125 patients were included (52% male; mean age, 59 years), of which 80 had type II achalasia (64%), and 38 had Chagas disease (30%). The average pre-procedure and post-procedure Eckardt scores were 6.79 and 1.87, respectively. Technical success was achieved in 93.5% of patients, and clinical success was achieved in 88.8%. Adverse events occurred in 27 patients (22%) and included bleeding (4 patients), pneumothorax (4 patients), mucosal perforation (13 patients), mediastinitis (2 patients), and leakage (4 patients).<br/> The CUSUM chart showed a median procedure time of 97 min (range, 45-196 min), which was achieved at the 61st procedure. Procedure duration progressively decreased, with the last 10 procedures under 50 min approaching a plateau (p-value <0.01).
conclusionMastering POEM in Latin America requires approximately 61 procedures for both POEM efficiency and to accomplish the procedure within 97 minutes.
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