The impact of flexible endoscopy in esophageal surgery

Nieponice, Alejandro; Nachman, Fabio; Badaloni, Adolfo; Ciotola, Franco; Zubieta, Cecilia; Ramirez, Mauricio

doi:10.21037/jtd.2017.05.61

Cited by 2 publications

(1 citation statement)

References 45 publications

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“…Proponents of POEM envision a complete endoscopic treatment algorithm, that allows for the replacement of the LHM with partial fundoplication. Before discussion of ways to treat GERD, it is important to note that despite creation of a partial fundoplication during Heller myotomy, there is still evidence that GERD is present in 21-41.7% of patients (12)(13)(14). The incidence of post-POEM GERD rates is 8.5-21%, as discussed in the previous section (7)(8)(9)(10)(11).…”

Section: Endoscopic Management Of Gerdmentioning

confidence: 97%

A Narrative Review of update in per oral endoscopic myotomy (POEM) and endoscopic esophageal surgery

Delliturri¹,

Wiesel²,

Shaw³

et al. 2021

Ann Transl Med

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The field of endoscopic esophageal surgery is based on the concept of natural orifice transluminal endoscopic surgery (NOTES). Submucosal space surgery or third space surgery with the use of flexible endoscopy allows for decreased morbidity and hospital length of stay with equivalent outcomes for patients. In the case of achalasia, per oral endoscopic myotomy (POEM) allows for management of refractory cases in setting of previous Heller Myotomy or in patients whom laparoscopic or thoracoscopic surgery is contraindicated. Lastly, POEM more directly divides circular muscular layer of esophagus without destroying surrounding structures that exist to prevent reflux. The innovations in endoscopic surgery began in the animal lab with experiments in the porcine model to develop a way to access the peritoneal cavity through an entry point in the gastric mucosa. Over the last 10 years, the biggest treatment innovations in endoscopy have focused on management of achalasia with the use of POEM. POEM became possible as technology was developed that revolutionized the use of flexible technology and the methods of mucosal closure. In addition to benign esophageal disease, endoscopic methods improved in management of esophageal malignancy with endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The innovations of endoscopic surgery have been developed through the utilization of the submucosal space as a method to ensure adequate closure of the mucosal entry point into the peritoneal cavity. The goal of this review paper is to explore POEM and other techniques in endoscopic esophageal surgery for the management of esophageal diverticulum, submucosal tumors, gastroparesis, and gastrointestinal esophageal reflux disease.

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Section: Endoscopic Management Of Gerdmentioning

confidence: 97%

A Narrative Review of update in per oral endoscopic myotomy (POEM) and endoscopic esophageal surgery

Delliturri¹,

Wiesel²,

Shaw³

et al. 2021

Ann Transl Med

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Endoscopic Intramural Surgery Part II: Muscular Division

Barajas‐Gamboa¹,

Corcelles²,

Kroh³

2018

Dig Dis Interv

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The development of endoscopic technologies and the introduction of new surgical concepts during the last decade has led to an evolution of surgical treatment of gastrointestinal disorders including achalasia, gastroesophageal reflux, gastroparesis, inflammatory bowel disease, and tumors of the gastrointestinal tract. Intramural surgery creates a novel approach to perform muscular division, submucosal dissection, and tumor removal. These procedures have proven safe and effective, and increasingly are part of the surgical endoscopist's toolbox. Intramural surgical procedures include peroral esophagomyotomy (POEM), peroral pyloromyotomy (POP), Zenker's diverticulotomy, and submucosal tunneling and endoscopic resection (STER) of lesions. The objective of this article is to describe current intramural surgery procedures that comprise muscular division, as well as clinical outcomes and its impact on surgical endoscopic practices.

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The impact of flexible endoscopy in esophageal surgery

Cited by 2 publications

References 45 publications

A Narrative Review of update in per oral endoscopic myotomy (POEM) and endoscopic esophageal surgery

A Narrative Review of update in per oral endoscopic myotomy (POEM) and endoscopic esophageal surgery

Endoscopic Intramural Surgery Part II: Muscular Division

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