Su1510 PerOral Endoscopic Myotomy (POEM) for Achalasia: Pilot Case Series of a Western Referral Center

Per-oral endoscopic myotomy white paper summary

“…11 Indications, contraindications, and pre-procedural evaluation and preparation POEM appears to be a safe and effective alternative for the treatment of classic achalasia. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] However, its role and efficacy in patients with other hypertensive motor disorders, prior conventional achalasia treatments, end-stage achalasia, age extremes, and significant comorbid diseases is not clear.…”

“…Data were extracted from the 14 reports currently available in the English literature, 10 published as full articles and 4 in abstract form, with outcomes data based on a total of 804 patients. [12][13][14][15][16][17][18][19][20][21][24][25][26][27][28][29][30] In all series, therapeutic success was seen in O80% of patients, with dramatic reductions noted in the Eckardt score as well as the LES pressure. Only a small number of studies have reported efficacy based on objective assessment of esophageal emptying by timed barium esophagram (Table 3).…”

Peroral Endoscopic Myotomy for the Treatment of Achalasia in Children

“…POEM is a new technique for the treatment of achalasia that is gaining international consensus. In adults, POEM has an extremely low complication rate and excellent results at short-term follow-up (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)32,33). Because the first patients were treated in 2008, long-term results are still not available; however, the published results at 1 or 2 years are extremely promising.…”

“…Peroral endoscopic myotomy (POEM) has been recently introduced in clinical practice for the treatment of esophageal achalasia (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). POEM is performed using a flexible endoscope inserted through the oral cavity and consists of the dissection of the muscle fibers of the distal esophagus and the cardia, with a final result definitely similar to that of an LHM.…”

Peroral endoscopic myotomy safety data

“…Von Renteln et al [8] observed this event in 50% of patients (n ¼ 8 of 16) in his series, all treated with the placement of an 18G cannula in the lower right abdominal quadrant. In a series of 16 patients from Dusseldorf, Germany, pneumoperitoneum was observed in 1 patient (6.25%) and was managed conservatively [13]. In the series published by Hungness et al [7] Veress needle decompression of the pneumoperitoneum was required intraoperatively in 7 of 18 patients (39%).…”