Effect of peroral endoscopic myotomy in achalasia patients with failure of prior pneumatic dilation: A prospective case–control study

Ling, Tao; Guo, Huimin; Zou, Xiaoping

doi:10.1111/jgh.12570

Cited by 61 publications

(36 citation statements)

References 28 publications

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“…47 This study showed a significantly longer operation time in the patients with previous pneumatic dilations; however, the outcomes in terms of the efficacy and safety were similar in both groups. 47 Another study about the learning curve of POEM also showed that previous endoscopic treatment was one of the independent predictive factors of a longer procedure time. 48 However, there were also several contrary results that showed no significant difference even in operation time, efficacy, and safety.…”

Section: Previous Endoscopic and Surgical Treatmentmentioning

confidence: 84%

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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Section: Previous Endoscopic and Surgical Treatmentmentioning

confidence: 84%

Peroral Endoscopic Myotomy for Treating Achalasia and Esophageal Motility Disorders

Youn

Minami

Chiu

et al. 2015

J Neurogastroenterol Motil

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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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“…Previous management of achalasia, including BTI, PD or LHM, does not preclude POEM [11][12][13][57][58][59][60]. In a series published by Orenstein et al [13], 40 patients received a POEM procedure, and 40% of them had had at least one prior endoscopic or surgical procedure, including nine BTI, seven PD, three both BTI and PD and three prior LHM (two with Dor fundoplication).…”

Section: Botulinum Toxin Injectionmentioning

confidence: 99%

Achalasia: current treatment options

Familiari

Greco

Volkanovska

et al. 2015

Expert Review of Gastroenterology & Hepatology

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Achalasia is a rare esophageal motility disorder, characterized by impaired swallow-induced, lower esophageal sphincter (LES) relaxation and defective esophageal peristalsis. Unfortunately, there are no etiological therapies for achalasia. Patients present with dysphagia, chest pain and regurgitation of undigested food, often leading to weight loss. The currently available treatments have the common aim of relieving symptoms by decreasing the pressure of the LES. This can be achieved with some medications, by inhibiting the cholinergic innervation (botulinum toxin), by stretching (endoscopic dilation) or cutting (surgery) the LES. Recently, other therapeutic options, including per-oral endoscopic myotomy have been developed and are gaining international consensus. The authors report on the benefits and weaknesses of the different therapies and provide an updated approach to the management of achalasia.

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Effect of peroral endoscopic myotomy in achalasia patients with failure of prior pneumatic dilation: A prospective case–control study

Abstract: POEM is a promising therapeutic modality for achalasia patients who have failed to respond to PD therapy. Previous dilation procedures might have no obvious influence on the efficacy of POEM surgery.

Cited by 61 publications

References 28 publications

Peroral Endoscopic Myotomy for Treating Achalasia and Esophageal Motility Disorders

Peroral Endoscopic Myotomy for Treating Achalasia and Esophageal Motility Disorders

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

Achalasia: current treatment options

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