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
DOI
10.1053/j.gastro.2017.11.294