PDF(Pubmed)
Abstract：
OBJECTIVE: This retrospective single-center study aimed to assess the safety of early feeding in patients who met certain criteria following peroral endoscopic myotomy (POEM).
METHODS: Data from 100 patients who underwent POEM at our center between January and December 2022 were collected. Early feeding was defined as the introduction of clear liquid foods at 4 hours post procedure. At 4 and 24 hours, the pain was rated using the visual analog scale (VAS) in all patients. Patients without intraoperative complications (pneumoperitoneum requiring needle drainage, severe arterial bleeding requiring the use of hemostatic forceps, severe mucosal injury) and severe pain (VAS score > 6) and nausea-vomiting at the fourth postoperative hour were given the early feeding approach. In patients who did not meet these requirements, enteral feeding was initiated after 24 hours (late feeding).
RESULTS: Among the 100 patients, 50 patients were categorized early feeding. No patients had a control esophagogram. In the early and late enteral feeding groups, VAS scores were 4 (0-6) and 6 (1-8) (P< 001) at 4 hours and 1 (0-3) and 1 (0-6) (P = .043) at 24 hours, respectively. No severe complications were developed after early feeding. The median hospital stay in the early feeding group was 1 (1-3) day. There was no emergency readmission in any of early feeding patients.
CONCLUSIONS: Our study showed early feeding following POEM can be begun in achalasia patients who do not have intraoperative complications, severe pain, or nausea/vomiting.
METHODS: Data from 100 patients who underwent POEM at our center between January and December 2022 were collected. Early feeding was defined as the introduction of clear liquid foods at 4 hours post procedure. At 4 and 24 hours, the pain was rated using the visual analog scale (VAS) in all patients. Patients without intraoperative complications (pneumoperitoneum requiring needle drainage, severe arterial bleeding requiring the use of hemostatic forceps, severe mucosal injury) and severe pain (VAS score > 6) and nausea-vomiting at the fourth postoperative hour were given the early feeding approach. In patients who did not meet these requirements, enteral feeding was initiated after 24 hours (late feeding).
RESULTS: Among the 100 patients, 50 patients were categorized early feeding. No patients had a control esophagogram. In the early and late enteral feeding groups, VAS scores were 4 (0-6) and 6 (1-8) (P< 001) at 4 hours and 1 (0-3) and 1 (0-6) (P = .043) at 24 hours, respectively. No severe complications were developed after early feeding. The median hospital stay in the early feeding group was 1 (1-3) day. There was no emergency readmission in any of early feeding patients.
CONCLUSIONS: Our study showed early feeding following POEM can be begun in achalasia patients who do not have intraoperative complications, severe pain, or nausea/vomiting.
摘要：
目的：这项回顾性单中心研究旨在评估经口内镜下肌切开术（POEM）后符合某些标准的患者早期进食的安全性。
方法：收集了2022年1月至12月在我们中心接受POEM的100名患者的数据。早期喂养被定义为在程序后4小时引入透明液体食物。在4和24小时，采用视觉模拟量表(VAS)对所有患者的疼痛进行评分.无术中并发症的患者（气腹需要针引流，需要使用止血钳的严重动脉出血，术后第4小时给予严重粘膜损伤）和严重疼痛（VAS评分>6）和恶心呕吐。在不符合这些要求的患者中，肠内喂养在24小时后开始（晚期喂养）。
结果：在100名患者中，50名患者被归类为早期喂养。没有患者的食管造影对照。在早期和晚期肠内喂养组中，4小时VAS评分分别为4（0-6）和6（1-8）（P<001），24小时分别为1（0-3）和1（0-6）（P=0.043），分别。早期喂养后无严重并发症发生。早期喂养组的中位住院时间为1（1-3）天。任何早期喂养患者都没有紧急再入院。
结论：我们的研究表明，没有术中并发症的门失弛缓症患者可以在POEM后开始早期进食，剧烈疼痛,或恶心/呕吐。
方法：收集了2022年1月至12月在我们中心接受POEM的100名患者的数据。早期喂养被定义为在程序后4小时引入透明液体食物。在4和24小时，采用视觉模拟量表(VAS)对所有患者的疼痛进行评分.无术中并发症的患者（气腹需要针引流，需要使用止血钳的严重动脉出血，术后第4小时给予严重粘膜损伤）和严重疼痛（VAS评分>6）和恶心呕吐。在不符合这些要求的患者中，肠内喂养在24小时后开始（晚期喂养）。
结果：在100名患者中，50名患者被归类为早期喂养。没有患者的食管造影对照。在早期和晚期肠内喂养组中，4小时VAS评分分别为4（0-6）和6（1-8）（P<001），24小时分别为1（0-3）和1（0-6）（P=0.043），分别。早期喂养后无严重并发症发生。早期喂养组的中位住院时间为1（1-3）天。任何早期喂养患者都没有紧急再入院。
结论：我们的研究表明，没有术中并发症的门失弛缓症患者可以在POEM后开始早期进食，剧烈疼痛,或恶心/呕吐。
