Metabolites (Aug 2023)

Assessment of the Physical Invasiveness of Peroral Endoscopic Myotomy during the Perioperative Period Based on Changes in Energy Metabolism

  • Daisuke Chinda,
  • Tadashi Shimoyama,
  • Sae Fujiwara,
  • Masatoshi Kaizuka,
  • Kohei Yasuda,
  • Kazuki Akitaya,
  • Tetsu Arai,
  • Yohei Sawada,
  • Shiro Hayamizu,
  • Tetsuya Tatsuta,
  • Hidezumi Kikuchi,
  • Miyuki Yanagimachi,
  • Tatsuya Mikami,
  • Hirotake Sakuraba,
  • Shinsaku Fukuda

DOI
https://doi.org/10.3390/metabo13090969
Journal volume & issue
Vol. 13, no. 9
p. 969

Abstract

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A novel treatment method for achalasia of the esophagus and related disorders is known as peroral endoscopic myotomy (POEM). This study aimed to calculate the resting energy expenditure (REE) and evaluated the degree of physical invasiveness based on metabolic changes during the perioperative period of POEM. Fifty-eight patients who underwent POEM were prospectively enrolled; REE, body weight (BW), and basal energy expenditure were measured on the day of POEM, postoperative day 1 (POD 1), and three days after POEM (POD 3). The median REE/BW increased from 19.6 kcal/kg on the day of POEM to 24.5 kcal/kg on POD 1. On POD 3, it remained elevated at 20.9 kcal/kg. The stress factor on POD 1 was 1.20. Among the factors, including the Eckardt score, operation time, and the length of myotomy, the length of myotomy was associated with changes in REE/BW. During the perioperative period of POEM, the level of variation in energy expenditure was lower than that of esophageal cancer surgeries performed under general anesthesia. However, because the length of myotomy is a factor affecting changes in energy expenditure, careful perioperative management is desirable for patients with longer myotomy lengths.

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