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Objectives: We present an update on the (peroral endoscopic myotomy (POEM) difficulty score [PDS] by introducing a novel knife with waterjet functionality.
Methods: This is a retrospective review of patients who underwent POEM between May 2018 and July 2023 at the Kingston Health Sciences Center. Demographic and procedural variables were compared using descriptive and inferential statistics.
Peroral Endoscopic myotomy (POEM) in pediatric achalasia: a retrospective cohort on institutional experience and quality of life.
Orphanet J Rare Dis
January 2025
Department of Pediatric Gastroenterology and Nutrition, Amsterdam UMC, Emma Children's Hospital, Vrije Universiteit, Amsterdam, The Netherlands.
Background: Achalasia is a rare esophageal motility disorder with an estimated annual incidence of 1-5/100.000 and a mean age at diagnosis > 50 years of age. Only a fraction of the patients has an onset during childhood (estimated incidence of 0.
View Article and Find Full Text PDFThe A to Z of Peroral Endoscopic Myotomy.
J Clin Gastroenterol
February 2025
Digestive Disease and Surgery Institute, Cleveland Clinic London, UK.
Peroral endoscopic myotomy (POEM) is a novel technique within the field of third space endoscopy. The overarching principal is creation of a mucosal incision, careful dissection of the submucosal space using an electrosurgical knife to reach the muscularis (ie, tunneling), performing a controlled myotomy, and finally, closure of the mucosal incision. POEM was first developed for the management of achalasia, and now a decade of evidence shows the procedure is safe, effective, and highly reproducible.
View Article and Find Full Text PDFUpper Esophageal Sphincter Abnormalities and Esophageal Motility Recovery After Peroral Endoscopic Myotomy for Achalasia.
Dysphagia
November 2024
Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Article Synopsis
- A study investigated abnormalities in the upper esophageal sphincter (UES) in achalasia patients and the effects of peroral endoscopic myotomy (POEM) on the UES and esophageal body, revealing that 65.6% of participants had UES issues before treatment.
- Pre-treatment scores indicated greater difficulty swallowing and symptom severity in patients with UES abnormalities compared to those with normal UES functionality.
- Post-POEM results demonstrated a significant reduction in UES pressure and improved peristalsis in type II and III achalasia patients, although type I patients showed no contractility after the procedure.
Sling fiber preservation during POEM reduces incidence of postoperative reflux symptoms.
Dis Esophagus
January 2025
Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Gastroesophageal reflux disease (GERD) after peroral endoscopic myotomy (POEM) has been a limiting factor with POEM. Sling-fiber preservation during POEM was reported to reduce postoperative GERD in Japan. This study investigates the efficacy of this technique in a western population.
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