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Role of Peroral Endoscopic Myotomy (POEM) in the Management of Esophageal Diverticula
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Bogdan P. Miutescu, Sarah Khan, Shruti Mony, Mouen A. Khashab
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Clin Endosc 2020;53(6):646-651. Published online November 26, 2020
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DOI: https://doi.org/10.5946/ce.2020.262
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 Abstract
 PDF Supplementary Material PubReader ePub
- Esophageal diverticula are uncommon; however, when present, they can cause symptoms of dysphagia, regurgitation, and chest pain. Based on location and pathophysiological characteristics, they are classified as pulsion- and traction-type diverticula. In the past, the open surgical approach was the only treatment available; however, in the past few decades, transoral incisionless approaches in the form of rigid and flexible endoscopy have gained popularity. Diverticular peroral endoscopic myotomy has emerged as an alternative treatment option. In this paper, we reviewed the role of peroral endoscopic myotomy as a treatment option for different types of esophageal diverticula. Although a safe and effective procedure, this novel submucosal tunneling technique for the treatment of esophageal diverticula requires further validation, and head-to-head comparisons between the different approaches for the treatment of esophageal diverticula are warranted.
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Citations
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The Role of Peroral Cholangioscopy in Evaluating Indeterminate Biliary Strictures
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Nasim Parsa, Mouen A. Khashab
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Clin Endosc 2019;52(6):556-564. Published online July 16, 2019
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DOI: https://doi.org/10.5946/ce.2019.011
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Abstract
PDFPubReaderePub
- Biliary strictures are considered indeterminate when the initial radiologic evaluation and endoscopic retrograde cholangiopancreatography with brush cytology and/or forceps biopsy do not reveal diagnostic findings. Evaluation of these strictures is challenging and often requires a multidisciplinary approach and multiple procedures. Peroral cholangioscopy allows direct visualization of these lesions and targeted tissue acquisition using miniature biopsy forceps. In the past decade, there have been significant improvements in the field of cholangioscopy. These advances have allowed higher-quality image acquisition, easy setup, operation by a single operator, easy maneuverability, and excellent targeted tissue sampling performance. However, the interpretation of cholangioscopic visual findings remains challenging. In this review, we discuss the role of peroral cholangioscopy in the evaluation of indeterminate biliary strictures.
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