A Comparative Study on Comprehensive, Objective Outcomes of Laparoscopic Heller Myotomy With Per-Oral Endoscopic Myotomy (POEM) for Achalasia

Bhayani, Neil H.; Kurian, Ashwin A.; Dunst, Christy M.; Sharata, Ahmed; Rieder, Erwin; Swanstrom, Lee L.

doi:10.1097/sla.0000000000000268

Cited by 285 publications

(160 citation statements)

References 20 publications

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“…One of the latest methods of treatment of achalasia is peroral endoscopic myotomy (POEM) in which, after separation of the mucosa and submucosa, the cutting of the circular muscle layer is performed. During 6 months of observation, the outcomes of treatment were comparable to the classical myotomy; however, the patients complained of the symptoms of reflux disease [24]. The most frequently performed procedure in the case of achalasia is laparoscopic cardiomyotomy via the transabdominal or transthoracic approach.…”

Section: Discussionmentioning

confidence: 87%

Benign diseases of the gastro-oesophageal junction

Nawacki¹,

Głuszek²,

Kuder³

2016

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Introduction: Benign diseases of the gastro-oesophageal junction are among the most frequent gastroenterological diseases, and include hiatal hernia of the diaphragm, gastro-oesophageal reflux, and oesophageal achalasia. The first two entities are frequently concomitant diseases; therefore, sometimes it is difficult to differentiate from which disease dominant symptoms are seen in a patient. Due to their anatomical location the diseases of the gastro-oesophageal junction may imitate complaints on the part of other organs and systems. A patient with sharp stabbing pain in the chest would probably be diagnosed for coronary, and not reflux disease. This is related with delayed diagnosis and implementation of the proper treatment. Aim of the research: To demonstrate our own experiences in surgical management of diseases of the gastro-oesophageal junction, the available methods, and outcomes of treatment. Material and methods:Retrospective analysis was performed of medical records of patients hospitalised in one research centre due to diseases of the gastro-oesophageal junction. The type of disease, age, gender, treatment method, duration of surgical procedure, duration of hospitalisation, and the outcome of treatment were taken into consideration. Results and conclusions:The outcomes of treatment were compiled in the form of a table. It was confirmed that in the case of diseases of the gastro-oesophageal junction, surgical treatment is a very important element, with a low number of complications and very good therapeutic effect.

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Section: Discussionmentioning

confidence: 87%

Benign diseases of the gastro-oesophageal junction

Nawacki¹,

Głuszek²,

Kuder³

2016

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“…The development of reflux and PPI use does not appear to be significantly different between LHM and POEM (46,48). However, these series have small numbers and these outcomes may change when larger studies are conducted.…”

Section: Comparison To Laparoscopic Heller Myotomy (Lhm)mentioning

confidence: 92%

The current state of per oral endoscopic myotomy for achalasia

Smith

Louie

2017

J. Vis. Surg.

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Achalasia is an acquired neuromuscular disorder that has been treated using a variety of modalities throughout medical history. Recently, the technique of per oral endoscopic myotomy (POEM) was introduced to treat the disease using a truly minimally invasive, natural orifice technique that is rapidly being adopted across the world. This review outlines the development of POEM, the technique itself, and gives a comparison to other procedures, specifically laparoscopic Heller myotomy (LHM).

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“…[26][27][28] Moreover, as POEM does not involve the dissection of the diaphragmatic hiatus and division of the crura, the chances of post procedure gastroesophageal reflux disease are theoretically less than LHM. 29 We observed gastroesophageal reflux symptoms in 3 of our patients, and two of them were found to have mild esophagitis on endoscopy.…”

Section: Discussionmentioning

confidence: 99%

Per Oral Endoscopic Myotomy in Children with Achalasia Cardia

Nabi

Ramchandani

Reddy

et al. 2016

J Neurogastroenterol Motil

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Background/AimsAchalasia cardia (AC) is a motility disorder, characterized by impaired lower esophageal sphincter relaxation and absence of esophageal peristalsis. AC is rare in children with unclear optimum management strategies. Per oral endoscopic myotomy (POEM) is a novel technique for management of achalasia with encouraging results in adult patients. The efficacy and safety of POEM is not known for pediatric AC. The aim of our study was to evaluate the safety and efficacy of POEM in children with achalasia cardia MethodsThe data of all children (< 18 years) who underwent POEM at our center was retrospectively analysed. Symptoms were analysed using a validated score (Eckardt score) at regular predefined intervals. Objective parameters including high-resolution manometry, timed barium swallow and esophagogastroduodenoscopy were assessed before the procedure and at 1-year follow-up. Clinical success was defined as an Eckardt score ≤ 3. ResultsA total of 15 children underwent POEM during the specified period. Ten out of 15 (10/15) completed 1-year follow-up. Median operative time was 100 (38-240) minutes. Mean pre and post procedure LES pressure were 36.64 ± 11.08 mmHg and 15.65 ± 5.73 mmHg, respectively (P = 0.001). Mean Eckardt score before and after the POEM was 7.32 ± 1.42 and 1.74 ± 0.67, respectively (P = 0.001). Mean percentage improvement in barium emptying at 5 minutes was 63.70 ± 4.46%. All children had complete resolution of symptoms at 1 year. Median weight gain of children at 1 year was 0.65 kg (range, 0.0-4.6). Conclusions

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A Comparative Study on Comprehensive, Objective Outcomes of Laparoscopic Heller Myotomy With Per-Oral Endoscopic Myotomy (POEM) for Achalasia

Cited by 285 publications

References 20 publications

Benign diseases of the gastro-oesophageal junction

Benign diseases of the gastro-oesophageal junction

The current state of per oral endoscopic myotomy for achalasia

Per Oral Endoscopic Myotomy in Children with Achalasia Cardia

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