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POEM, the Prototypical "New NOTES" Procedure and First Successful NOTES Procedure.

Robert Bechara1, Haruhiro Inoue2

  • 1Digestive Diseases Centre, Showa University Koto-Toyosu Hospital, Toyosu 5-1-38, Koto-Ku, Tokyo 135-8577, Japan; Queen's University Division of Gastroenterology Kingston General and Hotel Dieu Hospitals, 166 Brock Street, Kingston, Ontario K7L 5G2, Canada.

Gastrointestinal Endoscopy Clinics of North America
|April 3, 2016
PubMed
Summary

Peroral endoscopic myotomy (POEM) is a safe and effective endoscopic surgery for achalasia, now proven durable long-term. It also successfully treats diffuse esophageal spasm and jackhammer esophagus.

Keywords:
AchalasiaDiffuse esophageal spasmHypercontractile esophagusJackhammer esophagusNatural orifice transluminal endoscopic surgery (NOTES)Peroral endoscopic myotomy (POEM)

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Peroral endoscopic myotomy (POEM) emerged in 2008 as a novel achalasia treatment.
  • POEM represents a significant advancement in natural orifice transluminal endoscopic surgery (NOTES).

Purpose of the Study:

  • To evaluate the long-term durability and efficacy of POEM.
  • To assess POEM's application in treating diffuse esophageal spasm (DES) and jackhammer esophagus.

Main Methods:

  • Review of extensive safety and efficacy data for POEM.
  • Analysis of long-term outcomes and application in spastic esophageal disorders.

Main Results:

  • POEM demonstrates durable long-term efficacy for achalasia.
  • POEM is effective for diffuse esophageal spasm and jackhammer esophagus.
  • Myotomy including the lower esophageal sphincter minimizes iatrogenic risks in these conditions.

Conclusions:

  • POEM is a safe, effective, and durable treatment for achalasia.
  • POEM offers a successful therapeutic option for DES and jackhammer esophagus.
  • Careful myotomy technique optimizes outcomes for spastic esophageal disorders.