Miotomía endoscópica por vía oral (POEM) para el tratamiento de la acalasia. Experiencia clínica inicial y resultados a corto plazo

M, Ricardo Mejía; D, Andrés Donoso; A., Erik Manríquez; B, Josefina Sáez; E, Fernando Crovari; N, Mauricio Gabrielli; M, Enrique Norero; M, Fernando Pimentel; V., Marco Ceroni; C., Rodrigo Muñoz; P., Allan Sharp

doi:10.1016/j.rchic.2017.03.004

Cited by 6 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,12 Since 2015, our group has developed the POEM technique and to the date we have accumulated an experience of over 100 cases, both in adult and pediatric patients, with excellent results and no morbidity or mortality. 12,13 Due to the completely endoscopic, less invasive nature of the procedure it may have some advantages over LHM, including less postoperative pain, better aesthetic results, shorter length-of-stay and recovery. Particularly during pregnancy, POEM avoids entering the abdominal cavity and eliminates the risk of injury to the uterus allowing it to be performed safely during any trimester.…”

Section: Discussionmentioning

confidence: 99%

“…A low incidence of morbidity with a perforation rate of less than 1% and specific benefits over LHM have been recognized, such as better results in type III achalasia and in patients with a previous LHM. 4,12 Since 2015, our group has developed the POEM technique and to the date we have accumulated an experience of over 100 cases, both in adult and pediatric patients, with excellent results and no morbidity or mortality. 12,13 Due to the completely endoscopic, less invasive nature of the procedure it may have some advantages over LHM, including less postoperative pain, better aesthetic results, shorter length-of-stay and recovery.…”

Section: Discussionmentioning

confidence: 99%

“…POEM technique was first reported in 2008 by Inoue et al 11 Since then, it has been widespread and positioned as a safe and effective alternative to treat achalasia. A low incidence of morbidity with a perforation rate of less than 1% and specific benefits over LHM have been recognized, such as better results in type III achalasia and in patients with a previous LHM 4,12 …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Case report: Per oral endoscopic myotomy (POEM) during pregnancy

Mejía

Sáez

Quitral

et al. 2023

Clinical Case Reports

View full text Add to dashboard Cite

Esophageal achalasia is the most frequent primary motor disorder of the esophagus, resulting in a peristalsis and failed relaxation of the lower esophageal sphincter (LES). Various treatments have been described. Endoscopic alternatives include botulinum toxin injection and pneumatic balloon dilation, but both tend to fail with time and usually repeated interventions are required. Laparoscopic Heller myotomy (LHM) has been considered the gold standard. The diagnosis of achalasia during pregnancy is extremely rare and optimal management remains unclear. Our aim was to report a successful per oral endoscopic myotomy (POEM) performed during pregnancy. A 40‐year‐old pregnant woman presented with esophageal achalasia during her first trimester. Her disease was diagnosed with high resolution esophageal manometry (HREM). Initially an expectant conduct was attempted, but dysphagia progressed during the first 6 weeks of follow‐up and an important weight loss was noticed. She underwent POEM at 15 weeks of gestation. After the procedure, she reported relief of both dysphagia and regurgitation, and her nutritional status improved. She delivered a healthy boy at term. During follow‐up, she remains without dysphagia, her upper GI endoscopy shows no esophagitis and her HREM reports a normal integrated relaxation pressure. In achalasia, as in other clinical conditions, therapeutic decisions during pregnancy should always consider both the welfare of the mother and the fetus. POEM is a purely endoscopic treatment and has been recognized as a safe procedure to treat achalasia, with postoperative clinical success comparable to LHM and potential benefits over it.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Case report: Per oral endoscopic myotomy (POEM) during pregnancy

Mejía

Sáez

Quitral

et al. 2023

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

“…This makes the procedure the most successful version of notes. (8,9) The success of POEM management of Achalasia has been measured primarily by two parameters, pressure of the LES and Eckardts score. (10).…”

Section: Discussionmentioning

confidence: 99%

Peroral Endoscopic Myotomy (Poem) for Achalasia Cardia: Prospective Case Series of 50 Patients.

Gulve¹,

Doiphode²,

Patil³

2020

PIJR

View full text Add to dashboard Cite

Achalasia cardia (AC) is a primary motility disorder of the esophagus, characterized by absent peristalsis along with incomplete relaxation of lower esophageal sphincter (LES). Laparoscopic Heller’s cardio-myotomy (LHM) was considered the gold standard for treatment of AC. POEM (Per Oral Endoscopic Myotomy) is fast emerging as an alternative modality of treatment for AC. It is as effective and with minimal morbidity but there have been reports of post-procedure reflux esophagitis in some percentage of patients. Here in our prospective study we have tried to analyze the efficacy and safety profile and complications of POEM in AC patients who underwent this procedure at a single tertiary care hospital.

show abstract

“…Con la introducción en humanos del POEM en el año 2008 por el Dr. Inoue, se abre un nuevo horizonte en el manejo de esta patología, actualmente con más de 5000 procedimientos a nivel mundial, con buenos resultados, convirtiéndose en el primer NOTES exitoso (3,15). Esta técnica quirúrgica también se ha empleado para trastornos motores de difícil manejo como el espasmo esofágico difuso y esófago de nutcracker/jackhammer (16,17,18).…”

Section: Discussionunclassified

Miotomía endoscópica por vía oral (POEM) para el tratamiento de Acalasia: nuestras primeras experiencias

Rodríguez-F

Mantilla-G

Pineda-O³

et al. 2018

Rev. Colomb. Gastroenterol.

View full text Add to dashboard Cite

Introducción: la miotomía endoscópica por vía oral (POEM) se diseñó inicialmente para el manejo de la acalasia, que es un trastorno crónico y progresivo de la motilidad esofágica con hipertensión del esfínter esofágico inferior (EEI), para la cual el manejo estándar, hasta ahora, ha sido la cirugía de Heller; sin embargo, esta nueva técnica ofrece resultados muy comparables y prometedores.Materiales y métodos: se realizó una revisión retrospectiva de las historias clínicas de los pacientes con acalasia operados por POEM en una institución de Colombia por un solo cirujano endoscopista.Resultados: se encontraron 4 pacientes con acalasia, todas con Eckardt ≥10 y presión EEI ≥30 mm Hg; el tiempo quirúrgico osciló entre 81-120 minutos; en el seguimiento, la reducción en la presión del EEI fue mayor al 50% prácticamente en todos los pacientes, encontrando valores cercanos a la normalidad y con resultados de Eckardt que demuestran éxito en la terapia POEM a los 2 meses de evaluación. Las complicaciones fueron resueltas en el intraoperatorio, con mortalidad de 0%. Conclusiones: El manejo de la acalasia mediante POEM ha demostrado ser una técnica eficaz y segura. Nuestros primeros hallazgos concuerdan con los resultados descritos en la literatura. Este es el primer paso para la implementación de este novedoso abordaje en el manejo de la acalasia en la población colombiana.

show abstract

Miotomía endoscópica por vía oral (POEM) para el tratamiento de la acalasia. Experiencia clínica inicial y resultados a corto plazo

Cited by 6 publications

References 21 publications

Case report: Per oral endoscopic myotomy (POEM) during pregnancy

Case report: Per oral endoscopic myotomy (POEM) during pregnancy

Peroral Endoscopic Myotomy (Poem) for Achalasia Cardia: Prospective Case Series of 50 Patients.

Miotomía endoscópica por vía oral (POEM) para el tratamiento de Acalasia: nuestras primeras experiencias

Contact Info

Product

Resources

About