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Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
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Endoscopic Myotomy for Foregut Motility Disorders.

Mouen A Khashab1, Petros C Benias2, Lee L Swanstrom3

  • 1Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland.

Gastroenterology
|February 19, 2018
PubMed
Summary

Peroral endoscopic myotomy (POEM) offers high success rates for achalasia and spastic esophageal disorders. This minimally invasive technique shows durable results and a low adverse event profile, with emerging applications in gastroparesis.

Keywords:
DysphagiaGastroparesisHeller MyotomyMyotomyPOEMReflux

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Endoscopic Procedures

Background:

  • Peroral endoscopic myotomy (POEM) is an advanced endoscopic technique.
  • It is primarily used for treating achalasia, a swallowing disorder.
  • The procedure involves submucosal tunneling and myotomy.

Purpose of the Study:

  • To review the efficacy and safety of POEM for achalasia.
  • To explore POEM's effectiveness in other esophageal motility disorders.
  • To discuss the emerging role of gastric POEM (G-POEM) in gastroparesis.

Main Methods:

  • Review of published studies on POEM, including over 6000 patients.
  • Analysis of clinical success rates, durability, and adverse events.
  • Evaluation of POEM for spastic esophageal disorders and G-POEM for gastroparesis.

Main Results:

  • Clinical success rates of 80%-90% in achalasia patients.
  • Demonstrated medium-term durability of response.
  • Low rate of adverse events with experienced operators.
  • Effectiveness shown for spastic esophageal disorders.
  • Promising initial results for G-POEM in gastroparesis.

Conclusions:

  • POEM is a highly effective and safe treatment for achalasia.
  • It is also beneficial for spastic esophageal disorders.
  • G-POEM shows potential for treating gastroparesis.