E0438 - Post POEM Procedure Metabolic Changes: A Single Center Retrospective Analysis

Adnan Khan, DO¹, Natalia Salinas Parra, BS², Heather M. Ross, BS², Sarah L. Chen, BA³, Brian M. Yan, BA³, Michelle Schafer, ⁴, Richard S. Kirby, ⁴, John Bruckbauer, ⁵, Alexis Gerber, MD⁴, Alexander Schlachterman, MD^4
1Thomas Jefferson University Hospital, Ballwin, MO; ²Sidney Kimmel Medical College, Philadelphia, PA; ³Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; ⁴Thomas Jefferson University Hospital, Philadelphia, PA; ⁵Thomas Jefferson University, Philadelphia, PA

Introduction: In the last decade, peroral endoscopic myotomy (POEM) has emerged as an effective endoscopic treatment for motility disease, specifically esophageal achalasia. The purpose of our study was to investigate 6-months and 1-year postoperative weight change in patients who underwent a POEM procedure.

Methods: We performed an IRB approved single center retrospective study. We evaluated patients diagnosed with achalasia who underwent a POEM procedure between 1/1/2017 and 12/30/2021. We extrapolated pre-procedural and post-procedural weight and albumin levels after 6 months and 1 year. All statistical analysis was completed with STATA.

Results: In six months, 68 patient post-POEM procedure weight increased 2.1%, which is statistically significant (p-value = 0.04). Female patients did not have a significant weight change, but male patients had a 5.0% increase (p = 0.006). For weight change at six months, patients less than 40 years old had a 5.7% increase (p=0.03), and patients between 60-79 had a 2.4% increase (p=0.02).




At one year, there was a 2.9% increase (p< 0.001) for all patients. Female patients did not have a significant change (p=0.17), but male patients had a 4.5% increase in weight (p< 0.001). Stratified by age, all groups had a statistically significant increase in weight except for patients >80 years old (p=0.29). Patients less than 40 years old had a 5.8% increase (p=0.005), 40- to 59-year-old patients had a 3.4% increase (p=0.006), and 60-79-year-old patients had a 2.9% increase (p=0.002). Weight at one year stratified by comorbidity (Obesity, Hyperlipidemia, Coronary Artery Disease, Diabetes Mellitus, and chronic kidney disease) showed no statistically significant change for any disease.




In 6 months and 1 year, the mean albumin level increased after POEM procedure (Pre procedure mean 3.69, six months mean 3.90, and 1-year mean 4.12); which was statistically significant (P =0.001)

Discussion: There was a statistically significant increase in both 6-month and 1-year postoperative weight and Albumin levels among all patients who underwent a POEM procedure. Male patients were significantly more likely to have an increase in postoperative weight than females. There was also a statistically significant increase in weight among patients age < 40, 40-59, and 60-79 1-year postoperatively. When stratified by comorbidities, there was no significant change in weight 1-year postoperatively. Further studies are indicated to better assess the consequences or benefits of postoperative weight gain.



Disclosures:


Adnan Khan, DO¹, Natalia Salinas Parra, BS², Heather M. Ross, BS², Sarah L. Chen, BA³, Brian M. Yan, BA³, Michelle Schafer, ⁴, Richard S. Kirby, ⁴, John Bruckbauer, ⁵, Alexis Gerber, MD⁴, Alexander Schlachterman, MD⁴. E0438 - Post POEM Procedure Metabolic Changes: A Single Center Retrospective Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.