Safety and feasibility of same-day discharge after peroral endoscopic myotomy in esophageal motility disorders: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is an effective treatment for esophageal motility disorders. There is limited data regarding the safety and feasibility of same-day discharge after POEM, and postoperative care lacks standardization. This study aims to assess the data on readmission rate, emergency department (ED) visits, and adverse events between same-day discharge (SDD) and admitted patients after POEM.

METHODS

Several databases were reviewed from inception to October 12, 2025. Outcomes of interest were readmissions, emergency department (ED) visits, adverse events, and post-procedural pain. Data were analyzed using a random-effect model.

RESULTS

Seven retrospective studies with a total of 637 patients (384 SDD, 253 admitted) were included in the final analysis. There was no significant difference in 30-day readmission rate, OR (95% CI): 0.72 (0.26, 1.98), and ED visits, OR (95% CI): 1.04 (0.40, 2.70) between the SDD and the admitted groups. Pooled rates (95% CI) for overall adverse events were 19.4% (7.6%, 41.3%), and among these, the pooled rates (95% CI) for intraoperative adverse events were 10.4% (6.6%, 16.2%).

CONCLUSIONS

In conclusion, the findings of this systematic review and meta-analysis indicate that same-day discharge after POEM is a viable management strategy in carefully selected patients and highlight opportunities to refine postoperative care protocols. Further prospective studies will be essential to validate these results and to better define standardized criteria for safe same-day discharge of patients undergoing the POEM procedure.