POEM: clinical outcomes beyond 5 years

Area of Science:

• Gastroenterology
• Surgical Innovation
• Endoscopic Procedures

Background:

• Peroral endoscopic myotomy (POEM) is a recognized short-term treatment for esophageal motility disorders.
• The long-term durability of POEM has been a subject of ongoing investigation.
• This study addresses the durability question with a large cohort and extended follow-up.

Purpose of the Study:

• To evaluate the long-term clinical outcomes of the POEM procedure.
• To assess the durability of POEM for various esophageal motility disorders.
• To determine patient satisfaction and need for re-intervention after POEM.

Main Methods:

• A retrospective analysis of patients who underwent POEM between 2010 and 2014.
• Long-term follow-up (≥5 years) was conducted via phone interviews to collect Eckardt symptom scores.
• Clinical success was defined as an Eckardt score < 3; overall success included freedom from additional interventions.

Main Results:

• 100 out of 138 patients completed follow-up, with a mean duration of 75 months.
• 91% of patients experienced dysphagia improvement, and 79% achieved long-term overall success.
• Symptom scores remained stable from short-term to long-term follow-up (mean Eckardt score 1 vs. 2, p=0.204), with 96% 5-year freedom from intervention.

Conclusions:

• POEM provides durable long-term treatment efficacy for achalasia and other esophageal motility disorders.
• Nearly 80% of patients maintain clinical success, demonstrating sustained benefits.
• POEM is a highly effective and satisfactory treatment option with lasting results.