Peroral Endoscopic Myotomy (POEM): Feasible as Reoperation Following Heller Myotomy

Vigneswaran, Yalini; Yetasook, Amy; Zhao, Jingjie; Denham, Woody; Linn, John G.; Ujiki, Michael

doi:10.1007/s11605-014-2496-2

Cited by 94 publications

(58 citation statements)

References 15 publications

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“…POEM has even been performed successfully on refractory cases of achalasia following previous balloon dilation or laparoscopic Heller myotomy [52][53][54][55]. These cases should only be treated by highly experienced operators [47].…”

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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“…required a median 7 (4-16) and 8 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) clips, respectively (p = 0.08). Length of stay was 1 day in each group.…”

mentioning

confidence: 99%

Prior treatment does not influence the performance or early outcome of per-oral endoscopic myotomy for achalasia

et al. 2015

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“…In addition, it has been shown that POEM is a feasible option for patients after a failed myotomy even in the presence of a fundoplication. Post-operative changes are not evident in these patients and the mean operating time is not affected by a previous myotomy [ 12 ]. Compared to LHM, which is currently viewed as the gold standard, POEM patients experience less pain, take fewer narcotics, and have a quicker return to activities of daily living (ADL) [ 13 ].…”

Section: Discussionmentioning

confidence: 97%