Peroral endoscopic myotomy: A short-term comparison with the standard laparoscopic approach

Ujiki, Michael; Yetasook, Amy; Zapf, Matthew; Linn, John G.; Carbray, JoAnn; Denham, Woody

doi:10.1016/j.surg.2013.04.042

Cited by 142 publications

(96 citation statements)

References 17 publications

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“…Initially described by Pasricha et al [41], this form of natural orifice transluminal endoscopic surgery (NOTES) has provided adequate symptom relief, shown similar shortterm results, and is less invasive as compared to laparoscopic Heller myotomy [42]. Short-term results have proven that POEM is a safe and effective approach for esophageal achalasia [43][44][45].…”

Section: Treatmentmentioning

confidence: 99%

Current status of achalasia management: a review on diagnosis and treatment

Tuason

Inoue

2017

J Gastroenterol

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Background Achalasia is a rare esophageal motility disorder that is characterized by loss of peristalsis and failure of relaxation of the lower esophageal sphincter (LES), particularly during swallowing. This review focuses on the diagnosis of esophageal motility disorders as defined by the Chicago Classification ver 3.0, and presents management options with regard to per-oral endoscopic myotomy (POEM) as the treatment of choice. Methods A concise review of literature was performed for articles related to the management of achalasia, and this was contrasted with our institution's current practice. Results Achalasia is still incompletely understood, and management is focused on establishing a proper diagnosis, and relieving the obstructive symptoms. Conclusions Achalasia should be considered when dysphagia is present, and not otherwise caused by an obstruction or inflammation, and when criteria is met as per the Chicago Classification ver 3.0. Lowering LES tone and disruption of LES can be accomplished by various methods, most notably pneumatic balloon dilatation and surgical myotomy. POEM has been gaining momentum as a first line therapy for achalasia symptoms, and can be considered an important tool for motility disorders of the esophagus.

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Section: Treatmentmentioning

confidence: 99%

Current status of achalasia management: a review on diagnosis and treatment

Tuason

Inoue

2017

J Gastroenterol

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“…Some studies also investigated the quality of life before and after POEM by using a standardized questionnaire, and showed that POEM provided significant improvement in the quality of life. [24][25][26][27] For objective measurements of efficacy, various parameters can be compared before and after the treatment of achalasia. The objective parameters include barium column height in timed barium esophagograms (TBE), 28,29 LES pressure, integrated relaxation pressure, 30 and GE junction distensibility as measured by EndoFLIP (Endolumenal Functional Lumen Imaging Probe; Crospon, Galway, Ireland).…”

Section: Short-term Outcomesmentioning

confidence: 99%

“…There have been also some reports of mediastinal leakage due to esophageal perforation, which needed thoracoscopic or laparoscopic drainage and extended hospital stay. 20,27,44 Complete and precise closure of the entry site and careful observation after starting solid foods are important to avoid this unfavorable complication.…”

Section: Complications Of Peroral Endoscopic Myotomymentioning

confidence: 99%

Peroral Endoscopic Myotomy for Treating Achalasia and Esophageal Motility Disorders

Youn

Minami

Chiu

et al. 2015

J Neurogastroenterol Motil

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Peroral endoscopic myotomy (POEM) is the application of esophageal myotomy to the concept of natural orifice transluminal surgery (NOTES) by utilizing a submucosal tunneling method. Since the first case of POEM was performed for treating achalasia in Japan in 2008, this procedure is being more widely used by many skillful endosopists all over the world. Currently, POEM is a spotlighted, emerging treatment option for achalasia, and the indications for POEM are expanding to include long-standing, sigmoid shaped esophagus in achalasia, even previously failed endoscopic treatment or surgical myotomy, and other spastic esophageal motility disorders. Accumulating data about POEM demonstrate excellent short-term outcomes with minimal risk of major adverse events, and some existing long-term data show the efficacy of POEM to be long lasting. In this review article, we review the technical details and clinical outcomes of POEM, and discuss some considerations of POEM in special situations.

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“…Peroral endoscopic myotomy (POEM) is a minimally invasive endoscopic approach to the Heller myotomy for achalasia. Over the past 6 years, research has verified its safety and effectiveness to treat achalasia [1,6]. Additionally, the endoscopic approach allows the physician to visualize varices, which may permit better avoidance of bleeding complications and easier implementation of precise electrocautery.…”

Section: Introductionmentioning

confidence: 99%

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

Shen

Wang

Zhang

et al. 2019

JGLD

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Achalasia is very uncommon, and rarely does achalasia co-exist with esophageal varices. We present a 62-year-old woman who was diagnosed with both achalasia and esophageal varices in December 2014 and had a past history of hematemesis. The patient’s achalasia symptoms’ Eckardt score was 9, and her hepatic function was Child-Pugh grade A6. After comprehensive assessment of the patient’s health and discussion of the pros and cons of various therapies for achalasia, the patient underwent a peroral endoscopic myotomy. She was symptom-free after the operation and had no recurrence of achalasia symptoms at 20-month follow-up. No adverse events were reported. Peroral endoscopic myotomy for achalasia with esophageal varices has not been previously reported in the English literature.Abbreviations: BTI: Botulinum toxin injections; EUS: Endoscopic ultrasonography; GEJ: Gastroesophageal junction; HIFU: High-intensity focused ultrasound; LHM: Laparoscopic Heller myotomy; PD: Pneumatic dilation; POEM: Peroral endoscopic myotomy; TIPS: Transjugular intrahepatic portosystemic shunt.

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Peroral endoscopic myotomy: A short-term comparison with the standard laparoscopic approach

Cited by 142 publications

References 17 publications

Current status of achalasia management: a review on diagnosis and treatment

Current status of achalasia management: a review on diagnosis and treatment

Peroral Endoscopic Myotomy for Treating Achalasia and Esophageal Motility Disorders

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a Patient with Esophageal Varices. A Case Report

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