Peroral Endoscopic Myotomy (POEM) for Esophageal Primary Motility Disorders: Analysis of 100 Consecutive Patients

Sharata, Ahmed; Dunst, Christy M.; Pescarus, Radu; Shlomovitz, Eran; Wille, Aaron J. T.; Reavis, Kevin M.; Swanström, Lee L.

doi:10.1007/s11605-014-2610-5

Cited by 201 publications

(105 citation statements)

References 26 publications

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“…19,36,[38][39][40][41][42] Most of these series demonstrated a sustained clinical success of POEM in > 90% of patients, with the follow-up duration ranging from 12 months to > 36 months. 19,36,[38][39][40][41][42] However, one international prospective multicenter study showed some decline in clinical success over time. 39 Von Renteln et al 39 demonstrated a 97% treatment success at 3 months, 88.5% at 6 months, and 82.4% at 12 months, which significantly declined from the initial treatment success.…”

Section: Long-term Outcomesmentioning

confidence: 98%

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: Long-term Outcomesmentioning

confidence: 98%

Peroral Endoscopic Myotomy for Treating Achalasia and Esophageal Motility Disorders

Youn

Minami

Chiu

et al. 2015

J Neurogastroenterol Motil

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“…It has shown that more than 90% of patients with type III achalasia were successfully cured by POEM with appropriate length of myotomy. Since POEM was first performed in Japan for resolving uncomplicated achalasia, its excellent outcomes allowed us to expand the range of disorders to include advanced sigmoid achalasia, failed surgical myotomy and even other spastic esophageal motility disorders [14] such as distal esophageal spasm [15] and Jackhammer esophagus [16]. The outcome of POEM for achalasia remains excellent up to 3 years after operation [12].…”

Section: Treatment Strategies For Achalasia Based On Subtypesmentioning

confidence: 99%

Diagnosis and Treatment Strategy of Achalasia Subtypes and Esophagogastric Junction Outflow Obstruction Based on High-Resolution Manometry

et al. 2017

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Background: Based on Chicago Classification version 3.0, the disorders of esophagogastric junction outflow obstruction (EGJOO) include achalasia (types I, II and III) and EGJOO. Although no curative treatments are currently available for the treatment of the disorders of EGJOO, medical treatments, endoscopic pneumatic dilation (PD), laparoscopic Heller myotomy (LHM), and per-oral endoscopic myotomy (POEM) are usually the sought-after modes of treatment. Since the etiology and pathogenesis might vary depending on the types of EGJOO disorders, treatment strategies should be considered based on those subtypes. Summary: Based on the accumulated evidences, the treatment strategies of our institution are as follows: effects of medical treatments on achalasia are limited. Either PD or LHM/POEM can be considered a first-line in achalasia type I, according to the patient's wish. PD and POEM can be considered first-line in achalasia types II and III, respectively. Conversely, In EGJOO, medical treatments including drugs like acotiamide and/or diltiazem can be tested as a first-line, and PD and POEM will be considered second and third-line treatments, respectively. Key Messages: The classification of subtypes based on high-resolution manometry will help us consider which treatment option can be selected as a first-line treatment depending upon the subtypes of disorders of EGJOO. Acotiamide has the potential to cure patients with EGJOO.

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“…Symptom relief in achalasia patients following POEM is excellent, as dysphagia and chest pain were resolved at rates of 98 % and 92 % respectively in the largest retrospective series to date [ 4 ]. In nonachalasia patients (DES, nutcracker esophagus, hypertensive LES) symptom relief was less impressive but sill greater than 70 % [ 4 ].…”

Section: Discussionmentioning

confidence: 98%