Clinical Endoscopy

Original Article

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; Clin Endosc 2020;53(3):321-327. Published online November 20, 2019; DOI: https://doi.org/10.5946/ce.2019.110

Background
/Aims: Peroral endoscopic myotomy (POEM) is a novel procedure for the treatment of achalasia and spastic esophageal disorders. Experience with POEM is limited, but its reported outcomes are excellent. It is deemed safe even for patients with prior interventions.
Methods
This retrospective review included patients who underwent POEM at a tertiary US center. POEM was performed in a multidisciplinary approach by advanced endoscopists and foregut surgeons. Clinical success was defined as a post-POEM Eckardt score ≤3.
Results
A total of 125 patients were included. Median follow-up period was 18 months (interquartile range, 10–22 months). Clinical success was achieved in 92% of patients and persisted at 12 months in 88% of patients. Mucosal barrier failure (MBF) occurred in 7 patients, 2 of whom required surgical intervention. MBF was more common in patients with prior laparoscopic Heller myotomy (19% vs. 3%, p=0.015). MBF requiring surgical intervention occurred early in the learning curve.
Conclusions
POEM is safe and effective in the treatment of achalasia and spastic esophageal disorders even after failed prior interventions.

Citations

Citations to this article as recorded by

Comparing clinical outcomes of peroral endoscopic myotomy for achalasia between Eastern and Western countries: a systematic review and meta-analysis
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Surgical and per-oral endoscopic myotomy (POEM) for the treatment of primary esophageal motility disorders: A systematic analysis of current trends in Germany between 2011 and 2019
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Diseases of the Esophagus.2021;[Epub] CrossRef
Spastic Motility Disorders: Diagnosis and Management in the Era of the Chicago Classification
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