Evidence map›Paper›PMID 36720757›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2023

Post-POEM Contrast-Enhanced Swallow Study: Is It Always Necessary?

Gabriel Szydlo Shein, Ram Elazary, Gad Marom, Yuri Fishman, Mahmud Abu Gazala, Ronit Brodie, Harold Jacob, Ariel A Benson, Avraham Rivkind, Alon J Pikarsky and 1 more

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Gabriel Szydlo SheinDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Ram ElazaryDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Gad MaromDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Yuri FishmanDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Mahmud Abu GazalaDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Ronit BrodieDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Harold JacobDepartment of Gastroenterology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Ariel A BensonDepartment of Gastroenterology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Avraham RivkindDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Alon J PikarskyDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Yoav MintzDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel. ymintz@hadassah.org.il.ORCID 0000-0002-5101-7449
Hadassah Medical Center · ILHebrew University of Jerusalem · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeroral endoscopic myotomy (POEM) is rapidly becoming the procedure of choice for treating esophageal achalasia. In most centers, contrast-enhanced swallow studies (CESS) are routinely performed postoperatively to confirm mucosal integrity. The aim of this study was to determine the necessity of performing these studies routinely after POEM.

methodsA retrospective review of a prospectively maintained database of patients who underwent POEM between December 2012 and November 2020 was performed. All patients underwent a CESS on the first postoperative day. Medical records including vital signs, complete blood count, and POD-1 CESS were evaluated.

resultsOne hundred thirty-four consecutive patients were included in the study. Sixty-nine (51.49%) CESS showed abnormal findings; while most findings did not change the postoperative course, five (7.2%) demonstrated tunnel leaks, which did alter the overall management. Screening patients for fever, tachycardia, or leukocytosis on POD-1 had a 100% sensitivity and a 62% specificity for finding a clinically significant complication on CESS.

conclusionsThe study findings suggest that performing routine contrast-enhanced swallow studies on all patients is not necessary following POEM, as leaks can be screened for by clinical or laboratory abnormalities. Herein, we propose an algorithm based on objective measurable findings for the selection of patients who should undergo CESS.

Indexed as

Digestive System Surgical ProceduresEsophageal AchalasiaEsophageal Sphincter, LowerEsophagoscopyHumansNatural Orifice Endoscopic SurgeryRadiographyRetrospective StudiesTreatment OutcomeAchalasiaContrast-enhanced swallow studyNOTESPeroral endoscopic myotomy (POEM)Tunnel leak

Identifiers

PMID36720757
OpenAlexW4318693035

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.