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A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem)

Tarik Akar.


Abstract
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), Zenker’s 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<0.05). Despite such a long follow-up, no patient has been re-administered to the hospital due to infection-related complications.
Conclusion: In this paper, we have shown that the application of prophylactic ‘systemic antibiotic and gentamicin tunnel lavage’ may not be required in POEM and similar procedures.

Key words: Peroral endoscopic myotomy, antibiotic, gentamicin, achalasia, dysphagia, infection


 
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How to Cite this Article
Pubmed Style

Tarik Akar. A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem). Ulutas Med J. 2021; 7(3): 193-202. doi:10.5455/umj.20210617094444

Web Style

Tarik Akar. A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem). https://www.ulutasmedicaljournal.com/?mno=88876 [Access: March 15, 2025]. doi:10.5455/umj.20210617094444

AMA (American Medical Association) Style

Tarik Akar. A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem). Ulutas Med J. 2021; 7(3): 193-202. doi:10.5455/umj.20210617094444


Vancouver/ICMJE Style

Tarik Akar. A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem). Ulutas Med J. (2021), [cited March 15, 2025]; 7(3): 193-202. doi:10.5455/umj.20210617094444


Harvard Style

Tarik Akar (2021) A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem). Ulutas Med J, 7 (3), 193-202. doi:10.5455/umj.20210617094444


Turabian Style

Tarik Akar. 2021. A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem). THE ULUTAS MEDICAL JOURNAL, 7 (3), 193-202. doi:10.5455/umj.20210617094444


Chicago Style

Tarik Akar. "A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem)." THE ULUTAS MEDICAL JOURNAL 7 (2021), 193-202. doi:10.5455/umj.20210617094444


MLA (The Modern Language Association) Style

Tarik Akar. "A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem)." THE ULUTAS MEDICAL JOURNAL 7.3 (2021), 193-202. Print. doi:10.5455/umj.20210617094444


APA (American Psychological Association) Style

Tarik Akar (2021) A Comparative Study Investigating the Necessity of Prophylactic ‘Systemic Antibiotic and Gentamicin Tunnel Lavage’ in Peroral Endoscopic Myotomy (Poem) and Similar Tunneling Procedures (Z-D-G Poem). THE ULUTAS MEDICAL JOURNAL, 7 (3), 193-202. doi:10.5455/umj.20210617094444


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