SAFETY AND EFFICACY OF PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: A CANADIAN EXPERIENCE
Bibliographic record
Abstract
Aims Evaluate the outcomes of POEM in our center. Methods Retrospective analysis on consecutive patients who underwent POEM for achalasia between July 2017 and September 2019. The primary end point is the reduction of the Eckardt Score after POEM by 3 points. Secondary end points are adverse event rate, duration of hospital stay. Results Twenty-eight patients (mean age 62±13 yo, 57% men) underwent POEM at our center during the study period. Most of patients had type 1 (n=12) or type 2 achalasia (n=10), and 6 had other dysmotility disorders. The average length of symptoms was 7.7 years (1-34). The average Eckardt score pre-POEM was 7.1 ± 2.4 (3-12). Technical success was achieved in 96% (n=27). One procedure failed because of mucosal perforation. Average duration of procedure was 85 ± 34 minutes (34-155). Length of myotomy were in average 11.2 cm. Most adverse events occurred during the procedure: bleeding and subcutaneous emphysema in 16 patients (57%) respectively, and pneumoperitoneum in 12 patients (43%). One patient had pneumothorax drained and admitted at ICU for four days, and one patient had delayed subcutaneous emphysema treated with endoscopic clips. The median length of hospital stay was 2 (2-7). The average Eckardt score at follow up was 1.2 ± 1.8 (0-8). The average Eckardt score variation was −5.9 ± 3.5 (−10-4). Twenty-five patients (89%) had a reduction by 3 or more of the Eckardt score. There was no difference with the type of achalasia: type 1=100% and type 2=90%. Conclusions Our data suggests that POEM is a promising procedure to improved patient with achalasia with a relatively low risk of complication and length of hospital stay.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".