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POEM, GPOEM, and ZPOEM.

Nasim Parsa1, David Friedel2, Stavros N Stavropoulos3

  • 1Division of Gastroenterology and Hepatology, University of Missouri Health System, Columbia, MO, USA.

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|April 2, 2022
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Summary
This summary is machine-generated.

Peroral Endoscopic Myotomy (POEM) and its variants, gastric POEM (GPOEM) and Zenker's diverticula POEM (ZPOEM), offer less invasive treatments for esophageal and gastric motility disorders. Comparative data and technique variations are reviewed.

Keywords:
AchalasiaGPOEMGastroparesisPOEMZPOEMZenker’s diverticulum

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Area of Science:

  • Gastroenterology
  • Advanced Endoscopy
  • Minimally Invasive Surgery

Background:

  • Peroral Endoscopic Myotomy (POEM) has transformed achalasia treatment, providing a less invasive alternative to laparoscopic Heller myotomy (HM).
  • Gastric POEM (GPOEM) and POEM for Zenker's diverticula (ZPOEM) are emerging endoscopic techniques for gastroparesis and hypopharyngeal diverticula, respectively.

Purpose of the Study:

  • To provide a comprehensive review of POEM, GPOEM, and ZPOEM, including indications, outcomes, technique variations, and comparative data.
  • To critically evaluate the role of POEM and its variants in advanced endoscopy and their comparison with traditional surgical approaches.

Main Methods:

  • Narrative review of existing literature on POEM, GPOEM, and ZPOEM.
  • Detailed discussion of technique variations, patient selection criteria, and comparative outcomes, including GERD after POEM and efficacy of GPOEM and ZPOEM.

Main Results:

  • POEM offers a less invasive approach to achalasia compared to HM, with ongoing debate regarding GERD rates.
  • GPOEM shows promise for gastroparesis, emphasizing patient selection, while ZPOEM demonstrates endoscopic superiority over surgery for hypopharyngeal diverticula, though not yet definitively over older endoscopic myotomy techniques.

Conclusions:

  • POEM and its adaptations represent significant advancements in endoscopic therapy for motility disorders.
  • Further research is needed to establish the long-term superiority of newer techniques like ZPOEM over established endoscopic methods.