Per-oral endoscopic myotomy (POEM): a new endoscopic treatment for achalasia

García, Pablo Miranda; Seoane, Fernando; Gonzalez, Jean‐Michel; Barthet, Marc; Vaquero, Cecilio Santander

doi:10.17235/reed.2017.4732/2016

Cited by 5 publications

(2 citation statements)

References 77 publications

(84 reference statements)

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“…Currently, there is no standard technique adopted by all health centers for the treatment of achalasia, with variations in periprocedural management between them. Despite the good results, excellent efficacy and safety of POEM are commonly reported, clinical success rates and adverse events vary between healthcare providers 15 , 20 . In this study, the results of the procedure were evaluated with a description of the technique used for reproduction and comparison with other healthcare centers.…”

Section: Discussionmentioning

confidence: 99%

Peroral Endoscopic Myotomy for Achalasia: Safety Profile, Complications and Results of 94 Patients

PRADO JUNIOR,

MACHADO,

PRADO

et al. 2023

ABCD, arq. bras. cir. dig.

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BACKGROUND: Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the aim of improving patients’ symptoms. Peroral endoscopic myotomy (POEM) is an alternative endoscopic surgery to Heller cardiomyotomy, in which the procedure is performed orally, by endoscopy, offering efficacy comparable to surgical myotomy, with relative ease and minimal invasion, without external incisions. AIMS: To study the safety of POEM by analyzing its results, adverse events and perioperative complications and the main ways to overcome them, in addition to evaluating the effectiveness of the procedure and the short-term postoperative quality of life. METHODS: A qualitative and quantitative, observational and cross-sectional study that analyzed patients who underwent the POEM in a reference center, from December 2016 to December 2022, maintaining the technical standard of pre-, peri- and postoperative protocol. RESULTS: A total of 94 patients were included in the study, and only three had postoperative complications. The average early postoperative Eckardt score was 0.93 and the late 1.40, with a mean improvement of 7.1 in early results and 6.63 in late results (p<0.05). CONCLUSIONS: POEM can be reproduced with an excellent safety profile, significant relief of symptoms and improvement in esophageal emptying, and in quality of life.

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Section: Discussionmentioning

confidence: 99%

Peroral Endoscopic Myotomy for Achalasia: Safety Profile, Complications and Results of 94 Patients

PRADO JUNIOR,

MACHADO,

PRADO

et al. 2023

ABCD, arq. bras. cir. dig.

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“…Indicators confirming the identification of GEJ include narrowing of the submucosal space, the appearance of small spiral blood vessels or commas in the submucosa, and visualization of the blue gastric cardia intraluminal mucosa. 9,10 Once the GEJ has been identified, the endoscope should advance approximately 2 to 3 cm past the GEJ. 9 Myotomy is the third step in POEM, where the circular muscle fiber dissection begins 6 cm above the GEJ and extends to 2-3 cm below the GEJ for a total length of 8-10 cm.…”

Section: Peroral Endoscopic Myotomymentioning

confidence: 99%

Gerd-Q Score As Outcome Parameter Of Anterior vs. Posterior Peroral Endoscopical Myotomy in Acalasia Patient

Insyira¹,

Mahendra²,

Yasa³

et al. 2022

InaJGHE

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Achalasia is an esophageal motility disorder which is characterized by relaxation failure of the lower esophageal sphincter and absence of distal esophageal peristalsis. The prevalence rate of achalasia is 10 cases per 100,000 population with dysphagia, regurgitation, chest pain, and weight loss as the main clinical manifestations. Target of treatment for achalasia is a decreased resting pressure in the lower esophageal sphincter and this can be achieved using peroral endoscopic myotomy (POEM). POEM can be performed using two therapeutic approaches: anterior and posterior. Complication that often occurs after POEM is Gastroesophageal Reflux Disease (GERD). GERD leads to symptoms and/or structural damage that affects the patient’s quality of life. The GERD questionnaire (GERD-Q) is a sensitive and non-invasive screening tool for diagnosing GERD. Based on the result analysis of this research that was conducted to assess the outcome of anterior and posterior POEM with the GERD-Q score parameter, there was no significant difference in scores between the anterior and posterior approaches.

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Advances in POEM for Achalasia: Optimal Technique, Post-POEM GERD

Miuţescu

Tanţău

Khashab

2020

Curr Treat Options Gastro

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Per-oral endoscopic myotomy (POEM): a new endoscopic treatment for achalasia

Abstract: POEM is an effective treatment for achalasia and is a promising tool for other motor esophageal disorders. It is a safe procedure but, due to its technical difficulty and possible associated complications, the procedure should be performed in referral centers by trained endoscopists.

Cited by 5 publications

References 77 publications

Peroral Endoscopic Myotomy for Achalasia: Safety Profile, Complications and Results of 94 Patients

Peroral Endoscopic Myotomy for Achalasia: Safety Profile, Complications and Results of 94 Patients

Gerd-Q Score As Outcome Parameter Of Anterior vs. Posterior Peroral Endoscopical Myotomy in Acalasia Patient

Advances in POEM for Achalasia: Optimal Technique, Post-POEM GERD

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