Introduction: Peroral endoscopic myotomy (POEM) and similar procedures (Z-D-G POEM) are one of the most remarkable topics recently in the gastroenterology community. In this paper, we aimed to investigate the necessity of prophylactic 'systemic antibiotic and gentamicin tunnel lavage in these procedures.
Materials and Methods: From August 2018 to May 2021, we performed Achalasia POEM (35), Zenkers POEM (3), Diverticulum POEM (1), and Gastric POEM (2). Of these, 21 patients received prophylactic systemic antibiotic and gentamicin tunnel lavage and the others (20 patients) nothing. The primary topics of the research were an adverse event, fever, changes in inflammatory markers(c-reactive protein (CRP), white blood cell(WBC), the length of hospital stay, and re-admission rate to the hospital.
Results: The mean age was 46.96±15.44 (21-78) and male/female ratio was 26 (67.9%) /15 (32.1%). Comparing groups with and without antibiotics, there was no difference between the two groups as to several adverse events, hospital stay, fever, levels of CRP, and WBC count(all p-values>0.05). The median CRP values on day 1 and day 3 were somewhat high in the antibiotic negative group but were not statistically different (p:0.667 and p:0.839). The median values of WBC of days 1, 3, and 5 were similar in both groups (all p-values>0.05). The mean follow-up days were 396±182.7 and 197.7±18.62 in the antibiotic (+) and antibiotic (-) groups, respectively (p
Key words: Peroral endoscopic myotomy, antibiotic, gentamicin, achalasia, dysphagia, infection
|
