Is peroral endoscopic myotomy (POEM) more effective than pneumatic dilation and Heller myotomy? A systematic review and meta-analysis

Perioperative outcomes of inpatient laparoscopic Heller myotomy and per-oral endoscopic myotomy in the United States

“…11,13,15,19,21 However, in addition to the small sample size of these studies, their retrospective designs do not allow definitive conclusions owing to the significant biases introduced when comparing such outcomes in noncontrolled, noncontemporaneous cohorts. 27 The current reported rates of perioperative adverse events with POEM range from 5% to 24.2%, 13,39,40 and 9 recent comparative studies of LHM to POEM have shown similar perioperative adverse events rates between the 2 procedures. 12e16,19e22 A large retrospective multicenter study from 12 tertiary-care centers (5 in the United States, 4 in Europe, 2 in Asia, and 1 in Australia) that included 1,826 patients who had POEM (without a group of patients that had LHM) between 2009 and 2015 reported an overall rate of adverse events requiring intervention as 7.5%, with y The Rao-Scott c 2 test does not provide a P value when 1 cell value equals 0.…”

A rare complication: Tension pneumothorax after peroral endoscopic myotomy

“…13 POEM has been reported as an effective and safe procedure for achalasia. [3][4][5][6] During POEM, a submucosal bleb is created in the mid-esophagus and the endoscope is inserted into the submucosal tunnel, which can be referred to as the third space. Gas is insufflated via the endoscope into the submucosal tunnel.…”

“…Various studies have reported the efficacy and safety of POEM. [3][4][5][6] There are some POEM-related complications, including infections, pleural effusion, major bleeding, and viscus perforation; among them, the most common are gas-related complications such as subcutaneous emphysema, pneumomediastinum, pneumoperitoneum, and pneumothorax. [7][8][9] A recent meta-analysis has reported that the incidence rate of pneumothorax during or after POEM is 1.2%.…”

Does Achalasia Subtype III Need to Be Treated Differently Than Type I and II? Con Argument

“…Therefore, currently LHM and Per-oral endoscopic myotomy (POEM) are the most common interventions performed for all types of achalasia with equivalent symptomatic outcomes and equivalent needs for reintervention. [5][6][7] In a recent study, POEM and LHM were compared across achalasia subtypes. 5 There were 21 patients with Type III achalasia and this study did not show any difference between treatment approach and outcomes.…”