P338 Assessing oesophageal clearance in post peroral endoscopic myotomy: introducing a novel technique

Abstract

Introduction The novel technique to assess the oesophageal clearance using multichannel Iintraluminal impedance transit (MIIT) technique seems promising1 which has not been utilised in postsurgical outcomes. This study investigates the clinical usefulness of this novel technique in patients undergone peroral endoscopic myotomy (POEM) with respect to treatment outcome. Method Patients were selected between January 2018 and December 2019 who had POEM procedure for achalasia and a post-POEM MIIT assessment. Patients gauged their severity of their dysphagia prior to POEM and again at the post POEM MIT assessment day using visual analogue scale. A reduction in dysphagia severity by ≥50% was considered a successful POEM which was also satisfactory outcome to patients. Statistical t-test, Fisher Exact tests and odd ratio (OR) were employed to assess for significant difference between treatment outcomes of POEM. A receiver operating curve (ROC) was used to assess the cut-off of oesophageal transit with respect to POEM treatment outcome. Results Total of 45 patients were selected (F:M=16:29, aged=25–76 years). 20/45 patients had a successful POEM and their IRPs were significantly lower than patients with failed POEM (5.7 mmHg vs 10.6 mmHg, p=0.0093). The Oesophageal transit time was also significantly reduced in the successful POEM outcome cohort of patients (5.3 mins vs 78.8 mins, p=0.0002). The ROC revealed that oesophageal transit time of Conclusion This novel technique successfully correlated with oesophageal clearance transit with respect to the POEM outcome and may be a suitable post-surgical assessment. Preliminary testing indicate oesophageal clearance within 10 minutes is satisfactory response to patients and thus would be considered successful POEM. This initial study is limited by small sample size. Reference Miahet al, Gut 2019;68:A214. [ https://gut.bmj.com/content/68/Suppl_2/A214.2 ]