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The Following is a summary of “Three-to-Six Month Post-Poem Timed Barium Esophagram Can Predict Esophageal Contents and May Stratify Aspiration Risk on Follow-Up EGD,” Published in the April 2025 Issue of the BMC Gastroenterology by Liberto et al.
Peroral Endoscopic Myotomy (POEM) has been beautiful to Widely Accept and Effective Endoscopic Treatment for Fikesia, Significantly Improving Esophageal Emptying and Reducing Sympts Associated with Impaired Esophageal Motility. Despite this, many patients who undergo poem continues to receiver endotracheal intubation (IS) During Follow-up esophagogastrodoscopy (EGD) as the precication against aspiration. However, Routine Use of Ei May Lead to Increased Procedural Time, Healthcare Costs, and Anesthesia-Relaced Risks-Spatially in Patients Whose Esophageal Function Has Normalized. This Study Investigates Whether Findings From Timed Barium Esophagram (TBE), Performed Three to Six Months After Poem, Can Predict the Presence of Residual Esophageal Contents on Subsequent Egd, Thus Serving As Surrogate Marker of Aspiration Risk.
This Retrospective Analysis Included Patients with Findlasia Who Underwent Poem Between SEPTEMBER 2021 and October 2023 and Who Completed Both the Follow-Up TBE and Egd Within The 3–6 Month Post-Procedure Window. In alignment with institutional protocol, All Poients Were Instructed to Abstain from Solid Foods (But Allowed Clear Liquids) for Two Days Preceding Both Pre- and Post-Pem Egd to Minimize the Likeliod of Residual Contents. The Primary Objective was to Identify TBE Variables Associated with the Presence of Liquid or Solid Contents on EGD. Logistics regression was Used to Evaluate Predictive Factors, and Receiver Operating Characteristic (RO) Curve Analysis was Employed to Assess Diagnostic Accuracy and Determine Optimal Thresholds.
The Total of 48 Patients Met the Study’s Inclusion Criteria. Logistics Regression Analysis Revealed That Greater Barium Column Height at 5 Minutes Post-Ages Significantly Associated with the Presence of Esophageal Contents on Follow-Up (Odds Ratio (OR) = 1.36; P = 0.004). ROC Curve Analysis Demonstrated a Strong Predictive Performance of Barium Column Height, with an area Under the Curve (AUC) of 0.85. The Threshold Height of 7.0 cm at 5 minutes was identified as the optimal cutoff for predicting residual contents. In addition, the passage of a 13 mm barium tablet during tbe was inverted associated with esophageal contents (or = 0.03; p = 0.002), suggesting that succcessful bolus transit is a reliable indicator of adequate esophageal clearance.
Findings from this Study Support the Utility of A Timed Barium Esophagram in Stratifying Aspiration Risk During Follow-Up Egd After Poem. Specifically, the 5-Minute Barium Column Height of Less Than 7.0 cm and successful passage of a 13 mm tablet appear to predict an esophagus free of residual liquid or solid material following a 2-day solid food fast. These Parameters May Assist Clinicians in Identifying Post-Poem Patients Who Can Safely Undergo Egd Endotracheal Intubation, Thereby Reducing Unnecessary ANESThesia Exposure and Procedural Ineffits. TBE THUS HOLDS VALUE NOT ONLY IN ASSESSING POST-TREATMENT ESOPHAGEAL FUNCTION But AS A DECISION-SUPPORT Tool For Procedural Planning in Findlasia Management.
Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03838-7