4.2 Review

Peroral endoscopic myotomy for achalasia

Related references

Note: Only part of the references are listed.
Article Surgery

Long-term (17 years) subjective and objective evaluation of the durability of laparoscopic Heller esophagomyotomy in patients with achalasia of the esophagus (90% of follow-up): a real challenge to POEM

Attila Csendes et al.

Summary: Laparoscopic Heller Myotomy (LHM) is an effective surgical procedure for managing achalasia patients, with good long-term results confirmed by various evaluations. However, some patients may develop complications such as gastroesophageal reflux disease (GERD) and squamous-cell carcinoma (SCC) in the late follow-up period.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2022)

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Peroral endoscopic myotomy provides effective palliation in type III achalasia

Monisha Sudarshan et al.

Summary: This study aimed to investigate the effectiveness of POEM in patients with type III achalasia. The results showed that POEM surgery can improve symptoms and esophageal function in patients, with long-lasting effects and fast postoperative recovery. The incidence of complications in patients was low. Therefore, POEM can be considered as a first-line treatment for this subtype of the disease.

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Efficacy and safety of peroral endoscopic myotomy in 100 older patients

Hiroki Okada et al.

Summary: POEM is effective and safe for elderly patients, with sustained efficacy over 3 years postoperatively. Care should be taken regarding the risk of adverse events associated with delirium, especially in elderly patients.

ESOPHAGUS (2022)

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Is transoral incisionless fundoplication (TIF) an answer to post-peroral endoscopic myotomy gastroesophageal reflux? A multicenter retrospective study

Olaya I. Brewer Gutierrez et al.

Summary: The study demonstrates that using transoral incisionless fundoplication (TIF) after peroral endoscopic myotomy (POEM) for treating gastroesophageal reflux (GER) may be effective and safe. Results indicate significant improvements in PPI use, symptom severity, and quality of life in post-POEM patients undergoing TIF.

ENDOSCOPY (2022)

Article Surgery

Comparison of peroral endoscopic myotomy between de-novo achalasia and achalasia with prior treatment

Abdullah Ozgur Yeniova et al.

Summary: Peroral endoscopic myotomy is considered as an effective treatment for achalasia patients. This study compared the safety and efficacy of POEM in treatment-naive patients and those with prior treatment failure. Results showed that POEM is safe and equally effective for both groups up to 6 months post treatment.

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Risk factors for gastroesophageal reflux after POEM for achalasia: a systematic review and meta-analysis

Raquel Cristina Lins Mota et al.

Summary: This systematic review and meta-analysis suggest that a circular anterior approach may limit post-POEM GERD, especially for treatment naive patients and those who have not undergone Heller myotomy.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2021)

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Long-term outcomes of per-oral endoscopic myotomy compared to laparoscopic Heller myotomy for achalasia: a single-center experience

Alexander J. Podboy et al.

Summary: This study compared the long-term clinical efficacy of POEM versus HM for the treatment of achalasia. The results showed that both procedures have similar long-term efficacy, adverse event rates, and reflux rates, with POEM showing greater efficacy in Type III Achalasia.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2021)

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Early outcomes of peroral endoscopic myotomy with fundoplication for achalasia cardia - Is it here to stay?

Gaurav Patil et al.

Summary: POEM-F is a technically feasible procedure with reasonable short-term success. However, its durability, early success, and safety need to be reassessed in long-term studies before being widely applied in clinical practice.

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Blown-out myotomy: an adverse event of laparoscopic Heller myotomy and peroral endoscopic myotomy for achalasia

Joseph R. Triggs et al.

Summary: BOM is a common adverse event after myotomy for achalasia, associated with post-treatment symptom severity, achalasia type, and treatment modality. Pretreatment type III achalasia, LHM as opposed to POEM, and an increased post-treatment integrated relaxation pressure are risk factors for BOM development.

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Comparison of Short Versus Long Esophageal Myotomy in Cases With Idiopathic Achalasia: A Randomized Controlled Trial

Zaheer Nabi et al.

Summary: The study indicates that in patients with achalasia, short esophageal myotomy is comparable to long myotomy in terms of clinical success, operative time, and GERD. Short esophageal myotomy can reduce operating duration efficiently.

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Advanced achalasia: good candidate for peroral endoscopic myotomy

Shaotian Qiu et al.

Summary: POEM is increasingly accepted as the first-line treatment for achalasia, with proven efficacy and safety in patients with megaesophagus.

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Safety and efficacy of peroral endoscopic myotomy with standard myotomy versus short myotomy for treatment-naive patients with type II achalasia: a prospective randomized trial

Li Gu et al.

Summary: Among treatment-naive patients with type II achalasia, standard and short POEM were comparable in terms of providing treatment efficacy and improving quality of life at 1 year, whereas short POEM is technically simpler to perform and requires less procedure time. Moreover, the short POEM approach resulted in fewer cases of postoperative abnormal esophageal acid exposure.

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Intraoperative impedance planimetry (EndoFLIP™) results and development of esophagitis in patients undergoing peroral endoscopic myotomy (POEM)

Mikhail Attaar et al.

Summary: POEM is a minimally invasive treatment for achalasia, but it can lead to a high incidence of GERD postoperatively. This study found that FLIP measurements collected during POEM may help predict which patients are more likely to develop reflux esophagitis. However, subjective symptoms on quality of life questionnaires are not reliable indicators for determining which patients are at risk for esophagitis.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2021)

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Clinical outcomes of peroral endoscopic myotomy for achalasia in children: a systematic review and meta-analysis

Chunyu Zhong et al.

Summary: The study demonstrated that POEM is an effective and safe technique for treating pediatric achalasia, with high rates of technical and clinical success, significant improvement in symptoms post-procedure, and manageable rates of major adverse events and gastroesophageal reflux. Further randomized comparative studies are needed to determine the most effective treatment modality for pediatric achalasia.

DISEASES OF THE ESOPHAGUS (2021)

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Single-session endoscopic fundoplication after peroral endoscopic myotomy (POEM plus F) for prevention of post gastroesophageal reflux-1-year follow-up study

Amol Bapaye et al.

Summary: This study reported short-term outcomes of POEM+F, showing technical success and significant improvement in dysphagia. The incidence of post-POEM+F GER was low and acceptable, indicating that POEM+F is safe and reproducible.

ENDOSCOPY (2021)

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POEM: clinical outcomes beyond 5 years

Sarah C. McKay et al.

Summary: The study demonstrates that POEM treatment for esophageal motility disorders has a long-term clinical success rate of nearly 80%, indicating that POEM is an effective treatment option with durable long-term efficacy for patients with achalasia.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2021)

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Outcomes of 100 Patients More Than 4 Years After POEM for Achalasia

Ryan A. J. Campagna et al.

Summary: POEM provides durable symptom relief and improvement in physiologic esophagogastric junction relaxation parameters over 4.5 years postoperatively. Reinterventions are rare and effective.

ANNALS OF SURGERY (2021)

Article Surgery

SAGES guidelines for the use of peroral endoscopic myotomy (POEM) for the treatment of achalasia

Geoffrey P. Kohn et al.

Summary: POEM is recommended for the treatment of achalasia, especially for subtype III. Consideration of patient concerns about continued postoperative PPI use is crucial in decision-making.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2021)

Article Gastroenterology & Hepatology

Landscape of Adverse Events Related to Peroral Endoscopic Myotomy in 3135 Patients and a Risk-Scoring System to Predict Major Adverse Events

Xinyang Liu et al.

Summary: This study systematically described the landscape of peroral endoscopic myotomy (POEM) related adverse events (AEs) and developed a predictive model and risk-scoring system to predict major AEs. Results showed that POEM is a safe procedure with low rates of severe AEs, and the prediction model demonstrated good performance in predicting major AEs.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2021)

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Peroral endoscopic myotomy: 10-year outcomes from a large, single-center US series with high follow-up completion and comprehensive analysis of long-term efficacy, safety, objective GERD, and endoscopic functional luminal assessment

Rani J. Modayil et al.

Summary: Peroral endoscopic myotomy (POEM) is highly safe and effective in long-term follow-up, with a clinical success rate of over 90% at >= 5 years, and only 2% of patients lacking follow-up assessments.

GASTROINTESTINAL ENDOSCOPY (2021)

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Per-oral endoscopic dual myotomy for the treatment of achalasia

Xianglei Yuan et al.

Summary: The dual-POEM procedure showed high efficacy and a favorable safety profile in treating patients with achalasia, with a clinical success rate of 94.1%. It significantly reduced symptoms and lower esophageal sphincter pressure, with some patients developing postprocedural reflux that was successfully treated with proton pump inhibitors.

ESOPHAGUS (2021)

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Same-Session Per-Oral Endoscopic Myotomy, Followed by Transoral Incisionless Fundoplication in Achalasia: Unjustified and Risky

Steven DeMeester et al.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2021)

Article Gastroenterology & Hepatology

Long-term clinical results of per-oral endoscopic myotomy (POEM) for achalasia: First report of more than 10-year patient experience as assessed with a questionnaire-based survey

Manabu Onimaru et al.

Summary: This study aimed to present the long-term clinical results of per-oral endoscopic myotomy (POEM) over 10 years and evaluate the technique and outcomes at the institution where it was first used in clinical settings. The results showed favorable clinical outcomes of POEM over 10 years, suggesting that POEM plays a significant role in the treatment of achalasia, even in patients who required additional treatments.

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Comparison of Objective Intermediate-Term Outcomes Between per-Oral Endoscopic Myotomy and Laparoscopic Heller Myotomy Show Equivalence

Marc A. Ward et al.

Summary: The study compared the intermediate-term outcomes of patients with esophageal motility disorders undergoing laparoscopic Heller myotomy (LHM) and per-oral endoscopic myotomy (POEM), finding that both procedures equally improved symptom resolution and esophageal physiology in the intermediate term.

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Per-oral endoscopic myotomy (POEM) for a sigmoid type of achalasia: short-term outcomes and changes in the esophageal angle

Shota Maruyama et al.

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Post-POEM reflux: who's at risk?

Gabriel Arevalo et al.

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ASGE guideline on the management of achalasia

Mouen A. Khashab et al.

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Cardiac arrest as a fatal periprocedural complication of peroral endoscopic myotomy (POEM)

Tomas Hucl et al.

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Morphologic Restoration After Peroral Endoscopic Myotomy in Sigmoid-type Achalasia

Hong Jin Yoon et al.

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ACG Clinical Guidelines: Diagnosis and Management of Achalasia

Michael F. Vaezi et al.

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Efficacy and safety of peroral endoscopic myotomy after prior sleeve gastrectomy and gastric bypass surgery

Jennifer M. Kolb et al.

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Outcome of peroral endoscopic myotomy in children with achalasia

Zaheer Nabi et al.

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The treatment of achalasia patients with esophageal varices: an international study

M. Pesce et al.

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Clinical and endoscopic predictors for intraprocedural mucosal injury during per-oral endoscopic myotomy

Yun Wang et al.

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Comparative efficacy of per-oral endoscopic myotomy and Heller myotomy in patients with achalasia: a meta-analysis

Chan Hyuk Park et al.

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Long-Term Efficacy of Peroral Endoscopic Myotomy for Patients with Achalasia: Outcomes with a Median Follow-Up of 36Months

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Peroral endoscopic myotomy and fundoplication: a novel NOTES procedure

Haruhiro Inoue et al.

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Gastroesophageal reflux disease after peroral endoscopic myotomy: lest we forget what we already know

Robert Bechara et al.

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Peroral endoscopic myotomy leads to higher rates of abnormal esophageal acid exposure than laparoscopic Heller myotomy in achalasia

Madhusudhan R. Sanaka et al.

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Per-oral endoscopic myotomy (POEM): mid-term efficacy and safety

Jan Martinek et al.

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A Retrospective Study of Peroral Endoscopic Full-Thickness Myotomy in Patients with Severe Achalasia

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Per-oral endoscopic myotomy for achalasia cardia: outcomes in over 400 consecutive patients

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Peroral endoscopic myotomy for the treatment of esophageal achalasia: systematic review and pooled analysis

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Endoscopic suture repair of a large mucosal perforation during peroral endoscopic myotomy for treatment of achalasia

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