Donatelli G, Cereatti F, Soprani A. Per Oral Endoscopic Myotomy for the Management of Achalasia in a Patient with Prior
Lap Band, Sleeve Gastrectomy, and Roux-en-Y Gastric Bypass.
Obes Surg 2021;
31:2843-2844. [PMID:
33856637 DOI:
10.1007/s11695-021-05370-5]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/06/2021] [Accepted: 03/22/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION
Achalasia after bariatric surgery is a rare pathological entity. Nonetheless, several cases have been described in literature. Per oral endoscopic myotomy has recently emerged as the preferred approach for the management of esophageal motility disorders.
MATERIAL AND METHODS
We report a video case of POEM performed in a female patient with prior multiple bariatric surgical procedures. In her past medical history, she underwent to laparoscopic lap band, sleeve gastrectomy, and Roux-Y-gastric bypass.
RESULTS
POEM was carried out without complication. Myotomy was performed only for 1 cm below the cardias due to the presence of the gastro-jejunal anastomosis. Post-operative course was uneventful and oral diet was restarted after one day. At 2 months follow-up, the patient is asymptomatic with no weight regain.
CONCLUSION
We report the first case of POEM after three different bariatric surgical procedure. Fibrosis due to prior interventions did not hampered POEM procedure, and the shorter myotomy due to the presence of small gastric pouch did not reduced its efficacy.
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