Impact of the COVID-19 pandemic on high-resolution manometry and peroral endoscopic myotomy for esophageal motility disorder in Japan.

Objectives To elucidate the impact of the coronavirus disease 2019 (COVID-19) on the practice of high-resolution manometry (HRM) and peroral endoscopic myotomy (POEM) in Japan. Methods We utilized a large-scale database involving 14 high-volume centers in Japan to investigate changes in the numbers of HRM and POEM procedures performed and outcomes of POEM between 2019 and 2020. A questionnaire survey was also conducted to analyze pandemic-associated changes in the HRM and POEM protocols. Results Compared to that in 2019, the number of HRM and POEM procedures decreased by 17.2% (1,587 to 1,314) and 20.9% (630 to 498), respectively. These declines were prominent during the state of emergency from April to May 2020, particularly in pandemic areas. HRM and POEM in non-pandemic areas were relatively unaffected. From 2019 to 2020, there was a 0.4% (254 to 248) decrease in POEM cases within the prefecture, but the number outside the prefecture decreased by 33.6% (372 to 247). During the pandemic, the safety and efficacy of POEM were maintained. The implementation of personal protective equipment measures (PPE) varied among facilities, but PPE for POEM was relatively insufficient compared to that for HRM. Conclusions The COVID-19 pandemic influenced HRM and POEM practices in Japan. It is necessary to establish a sufficient system for HRM and POEM in each hospital as well as countrywide to overcome the effects of the pandemic.