Successful treatment of diffuse esophageal spasm by peroral endoscopic myotomy

Shiwaku, Hironari; Inoue, Haruhiro; Beppu, Richiko; Nakashima, Ryo; Minami, Hitomi; Shiroshita, Toyoo; Yamauchi, Yasushi; Hoshino, Seiichiro; Yamashita, Yuichi

doi:10.1016/j.gie.2012.02.008

Cited by 105 publications

(63 citation statements)

References 6 publications

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“…POEM has been used for all types of esophageal motility disorders, including, but not restricted to, advanced sigmoid achalasia and spastic motility disorders of the esophagus [50,51]. POEM has even been performed successfully on refractory cases of achalasia following previous balloon dilation or laparoscopic Heller myotomy [52][53][54][55].…”

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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“…Since then, POEM has been one of the standard treatments for treating esophageal achalasia and related esophageal motility diseases, such as diffuse esophageal spasm and jackhammer esophagus. [8][9][10] Table 1 summarizes the general characteristics of POEM compared with laparoscopic Heller myotomy and pneumatic dilation.…”

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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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“…reported. 12,13 However, POEM has not been a widely chosen option yet in the treatment of Jackhammer esophagus. The reason is that this disease is a motility disorder which can affect a wide range of esophageal muscles, and the distribution could also be random.…”

Section: Case Reportmentioning

confidence: 99%

“…Likewise in the treatment of achalasia or other esophageal motility disorders, an appropriate length of the myotomy is a key factor affecting the clinical response. 12,18 By the definition of disease criteria, HRM is essential for the diagnosis of the definition of the Jackhammer esophagus, preprocedural HRM is surely the most important step. In addition, we think that the EUS also plays an important role in selection of patients who would be appropriate for POEM.…”

Section: Case Reportmentioning

confidence: 99%

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Jackhammer Esophagus Treated by a Peroral Endoscopic Myotomy

Lee

Park

et al. 2014

Korean J Gastroenterol

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A 49-year-old woman visited our hospital with dysphagia and chest pain. In another hospital, she was diagnosed as reflux esophagitis. Although she had taken proton pump inhibitor and prokinetics drugs for a long time, she was not relieved of any symptoms. On the basis of high resolution manometry and endoscopic ultrasonography findings, Jackhammer esophagus was diagnosed. In this patient, peroral endoscopic myotomy (POEM) was performed for long myotomy of thickened circular muscle. During the procedure, there were no significant complications and she was discharged uneventfully. Symptoms were completely improved during three months after POEM. Here, we report on a case of Jackhammer esophagus treated by POEM. (Korean J Gastroenterol 2014;64:370-374)

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Successful treatment of diffuse esophageal spasm by peroral endoscopic myotomy

Cited by 105 publications

References 6 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

Jackhammer Esophagus Treated by a Peroral Endoscopic Myotomy

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