AI Article Synopsis
- Peroral endoscopic myotomy (POEM) is a minimally invasive technique for treating achalasia, but it can lead to gastroesophageal reflux (GER), prompting a pilot study to combine POEM with endoscopic fundoplication (POEM+F) as a solution.* -
- In the study, POEM+F was successfully performed on 21 patients, featuring a method that involved creating a partial barrier at the esophagogastric junction using endoclips and an endoloop.* -
- The results showed that POEM+F was technically successful with no immediate complications, suggesting it may be a safer alternative to traditional laparoscopic procedures for reducing post-POEM GER.*
Article Abstract
Background: Peroral endoscopic myotomy (POEM) has become the minimally invasive endoscopic treatment for achalasia; however, gastroesophageal reflux (GER) post-POEM has been reported. A pilot study was conducted in which an endoscopic fundoplication was added to the standard POEM (POEM + F) procedure to overcome this issue. We report the technical details of POEM + F and short-term safety results.
Methods: POEM + F was performed in 21 patients. After completing myotomy, the endoscope was advanced from the submucosal tunnel into the peritoneal cavity. A partial mechanical barrier was created by retracting the anterior gastric wall at the esophagogastric junction with the use of endoclips and an endoloop.
Results: POEM + F was technically feasible in all cases and created a visually recognizable fundoplication. The clinical course after POEM + F was uneventful. No immediate or delayed complications occurred.
Conclusion: POEM + F may help mitigate the post-POEM incidence of GER and serve as a minimally invasive endoscopic alternative to a laparoscopic Heller-Dor procedure. This is the largest case series of peroral natural orifice transluminal endoscopic surgery without laparoscopic assistance in the human foregut.
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| http://dx.doi.org/10.1055/a-0820-2731 | DOI Listing |
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