Endoscopic Myotomy for Foregut Motility Disorders

Publication Date

2018

Journal Title

Gastroenterology

Abstract

© 2018 AGA Institute Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure classically performed for the treatment of achalasia. The procedure is based on principles of submucosal endoscopy and is composed of a mucosal incision, submucosal tunneling, myotomy, and mucosal closure. Multiple published studies that collectively include more than 6000 patients reported clinical success in more than 80% to 90% of patients. Recent literature also suggested durability of response over a medium-term follow-up. POEM is associated with a low rate of adverse events when performed by experienced operators. Gastroesophageal reflux is not infrequent after POEM but does not seem significantly different from reflux that occurs after Heller myotomy. POEM also seems to be effective in the treatment of spastic esophageal disorders (eg, jackhammer and diffuse esophageal spasm). Last, the role of gastric POEM (G-POEM) in the treatment of gastroparesis has been investigated in recent studies with promising results.

Volume Number

154

Issue Number

7

Pages

1901 - 1910

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

Gastroenterology

PMID

29454796

DOI

10.1053/j.gastro.2017.11.294

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