The treatment of patients with achalasia is complex due to a considerably high recurrence rate and risk of treatment-related complications. The per-oral endoscopic myotomy (POEM) is a new endoscopic technique that combines the benefits of a minimally invasive endoscopic procedure with the efficacy of a surgical myotomy. Implementation of the POEM technique may lead to fewer complications, a lower recurrence rate and reduced costs. During the procedure, a myotomy of the circular muscle layer of the oesophagus is performed after creating a submucosal tunnel in the oesophagus. The first studies of this new technique show promising results. Experienced therapeutic endoscopists can learn to perform the POEM technique relatively easily. Further studies are needed to compare this technique with the current standard treatments and to evaluate long-term effects.
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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 PDFObjectives: Achalasia is an esophageal motility disorder of unknown etiology. However, no studies have determined the populations in which sleep problems occur and whether they are improved by peroral endoscopic myotomy (POEM). We investigated the rate of sleep problems assessed by GERD-Q (AGQ) in achalasia patients, evaluated whether POEM improves these issues, and identified factors associated with sleep improvement after POEM.
View Article and Find Full Text PDFClinical Outcomes and Financial Impact of a POEM Program at a Rural Tertiary Medical Center: Our First five Years.
Innovations (Phila)
January 2025
Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA.
Objective: The purpose of this study was to assess the 5-year impact of a per oral endoscopic myotomy (POEM) program on both clinical and financial outcomes for our hospital system and the rural community we serve.
Methods: We evaluated the clinical and financial outcomes of all patients who underwent POEM for achalasia. Patients were also contacted by phone to complete the Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) questionnaire postoperatively.
Background: Predicting successful outcomes of gastric peroral endoscopic myotomy (G-POEM) is essential for identifying patients who are most likely to benefit from the procedure. This study aimed to evaluate the utility of the balloon dilation test (BDT) in optimizing patient selection for G-POEM.
Methods: A retrospective study was conducted from February 2021 to December 2023, including patients with refractory gastroparesis unresponsive to conventional medical treatments.
The Use of Knives With Versus Without Integrated Water-jet Function During Peroral Endoscopic Myotomy for Patients With Achalasia: A Meta-analysis.
Surg Laparosc Endosc Percutan Tech
January 2025
Department of Surgery, Division of Gastrointestinal Surgery, University of South Florida Morsani College of Medicine, Tampa, FL.
Background: Peroral endoscopic myotomy (POEM) is a well-established endoscopic treatment for achalasia, utilizing an endoscopic knife for dissection. Recently, new knives with an integrated water-jet (WJ) function have been introduced. This study aims to compare the technical, perioperative, and late postoperative outcomes between WJ knives and conventional (C) knives, which lack the WJ function, through a pairwise meta-analysis of published comparative studies.
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