Achalasia is an esophageal motility disorder characterized by incomplete relaxation of the lower esophageal sphincter (LES) and aperistalsis of the esophageal body. Treatment of achalasia is aimed at decreasing the resting pressure in the LES. Peroral endoscopic myotomy (POEM), derived from natural orifice transluminal endoscopic surgery (NOTES) and advances in endoscopic submucosal dissection (ESD), presents a novel, minimally invasive, and curative endoscopic treatment for achalasia. POEM involves an esophageal mucosal incision followed by creation of a submucosal tunnel crossing the esophagogastric junction and myotomy before closure of the mucosal incision. Although the procedure is technically demanding and requires a certain degree of skill and competency, treatment success is high (90%) with low complication rates. Since the first described POEM in humans in 2010, it has been used increasingly at centers worldwide. This article reviews available published clinical studies demonstrating POEM efficacy and safety in order to present a proposal on how to establish a dedicated POEM program and reach base proficiency for the procedure.

Citations

Citations to this article as recorded by  

• Esophageal bronchogenic cyst treated with submucosal tunneling endoscopic resection: two case reports
  Hui Sha, Zong-Dan Jiang
  Journal of Medical Case Reports.2024;[Epub]     CrossRef
• Efficacy of peroral endoscopic myotomy for the treatment of functional esophagogastric junction outflow obstruction
  Madhusudhan R. Sanaka, Prabhat Kumar, Abdul Mohammed, Rajat Garg, Prashanthi N. Thota, Scott Gabbard, Yi Qin, Monisha Sudarshan, Sudish Murthy, Siva Raja
  iGIE.2023; 2(4): 464.     CrossRef
• Per-oral Endoscopic Myotomy
  Jennifer Liu-Burdowski, Rodrigo Duarte-Chavez, Michel Kahaleh
  Journal of Clinical Gastroenterology.2022; 56(1): 16.     CrossRef
• How to Develop a Training Program for Third-Space Endoscopic Procedures in Western Countries
  Tony S. Brar, Patrick L. Stoner, Dennis Yang, Peter V. Draganov
  Current Treatment Options in Gastroenterology.2020; 18(2): 232.     CrossRef
• Establishing a submucosal endoscopy program in a gastrointestinal unit
  Poornima Varma, Payal Saxena
  International Journal of Gastrointestinal Intervention.2020; 9(2): 36.     CrossRef
• Experience with Peroral Endoscopic Myotomy for Achalasia and Spastic Esophageal Motility Disorders at a Tertiary U.S. Center
  Maen Masadeh, Peter Nau, Subhash Chandra, Jagpal Klair, John Keech, Kalpaj Parekh, Rami El Abiad, Henning Gerke
  Clinical Endoscopy.2020; 53(3): 321.     CrossRef
• POEM for Treatment of Achalasia: Our Early Experience and Technical Details of the Procedure
  Pravin R. Suryawanshi, Ashok R. Mohite
  Indian Journal of Surgery.2019; 81(5): 452.     CrossRef
• 2007–2019: a “Third”-Space Odyssey in the Endoscopic Management of Gastrointestinal Tract Diseases
  Anastassios C. Manolakis, Haruhiro Inoue, Akiko Ueno, Yuto Shimamura
  Current Treatment Options in Gastroenterology.2019; 17(2): 202.     CrossRef
• POEM in Latin America
  Michel Kahaleh, Ming-ming Xu, Felipe Zamarripa, Guadalupe Martínez, Vitor N. Arantes, Fernando Casas Rodriguez, Bismarck Castillo, Iman Andalib, Amy Tyberg, Arnon Lambroza, Monica Saumoy, Juan C. Carames, Alberto Baptista, Carlos Robles-Medranda, Hanna Lu
  Journal of Clinical Gastroenterology.2019; 53(8): e352.     CrossRef
• An Update on Current Management Strategies for Achalasia and Future Perspectives
  Ioana Smith, Michel Kahaleh
  Journal of Clinical Gastroenterology.2018; 52(4): 277.     CrossRef
• Treatment of Achalasia with Per-Oral Endoscopic Myotomy: Analysis of 50 Consecutive Patients
  Erica D. Kane, David J. Desilets, Donna Wilson, Marc Leduc, Vikram Budhraja, John R. Romanelli
  Journal of Laparoendoscopic & Advanced Surgical Techniques.2018; 28(5): 514.     CrossRef
• Per-oral endoscopic myotomy (with video)
  Rahul Pannala, Barham K. Abu Dayyeh, Harry R. Aslanian, Brintha K. Enestvedt, Sri Komanduri, Michael Manfredi, John T. Maple, Udayakumar Navaneethan, Mansour A. Parsi, Zachary L. Smith, Shelby A. Sullivan, Nirav Thosani, Subhas Banerjee
  Gastrointestinal Endoscopy.2016; 83(6): 1051.     CrossRef
• POEM, the Prototypical “New NOTES” Procedure and First Successful NOTES Procedure
  Robert Bechara, Haruhiro Inoue
  Gastrointestinal Endoscopy Clinics of North America.2016; 26(2): 237.     CrossRef
• Optical coherence tomography (OCT) prior to peroral endoscopic myotomy (POEM) reduces procedural time and bleeding: a multicenter international collaborative study
  Amit P. Desai, Amy Tyberg, Prashant Kedia, Michael S. Smith, Guadalupe Martinez, Felipe Zamarripa, Yecheskel Schneider, Helga Bertani, Marzio Frazzoni, Fernando Casas, Lauren G. Khanna, Arnon Lambroza, Nikhil A. Kumta, Ali Khan, Reem Z. Sharaiha, Sanjay S
  Surgical Endoscopy.2016; 30(11): 5126.     CrossRef
• UEG Week 2016 Poster Presentations
  
  United European Gastroenterology Journal.2016; 4(5_suppl): A157.     CrossRef
• Idiopathic (primary) achalasia: a review
  Dhyanesh A. Patel, Hannah P. Kim, Jerry S. Zifodya, Michael F. Vaezi
  Orphanet Journal of Rare Diseases.2015;[Epub]     CrossRef
• Per-Oral Endoscopic Myotomy (POEM) After Previous Laparoscopic Heller Myotomy Is Feasible and Safe in a Porcine Model
  Luke F. Miles, Matthew J. Frelich, Jon C. Gould, Kulwinder S. Dua, Eric S. Jensen, Andrew S. Kastenmeier
  Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2015; 25(5): 408.     CrossRef
• Peroral endoscopic myotomy: an evolving treatment for achalasia
  Robert Bechara, Haruo Ikeda, Haruhiro Inoue
  Nature Reviews Gastroenterology & Hepatology.2015; 12(7): 410.     CrossRef