Peroral endoscopic esophagocardiomyotomy in elderly and senile patients

INTRODUCTION. Currently, the usage of esophagocardiomyotomy (POEM) in elderly and senile patients as a first-line treatment remains a subject of discussion.

METHODS AND MATERIALS. Between 2014 and 2023, POEM was performed in 99 patients over the age of 60. The mean age of the patients was 71 years (60–88 y. o.), with a predominance of females (65/34). Immediate postoperative outcomes were evaluated in all patients. Long-term results of the intervention were assessed in 67 patients (67.7 %) who were able to complete questionnaires and follow up.

RESULTS. POEM was successfully performed in all clinical cases. Two adverse events were marked by the features of the perioperative period associated with comorbidities. A positive effect after operation was observed in 63 (94 %) of the 67 patients available for follow-up, characterized by a reduction in dysphagia severity to ≤3 points on the Eckardt scale. In 4 cases out of 67 (5.9 %), a repeat POEM was necessary due to recurrence of complaints and symptoms of the disease.

CONCLUSION. The results of the study demonstrate that age, duration of the disease, comorbidities and previous interventions on the esophagus do not affect the outcomes of POEM.

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