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Peroral Endoscopic Myotomy for Treatment of Achalasia: Initial Results of a Korean Study

BACKGROUND/AIMS: Achalasia is a rare esophageal motility disorder. Recently, a novel endoscopic technique, peroral endoscopic myotomy (POEM), was introduced as an alternative treatment for achalasia. We report the results and short term outcomes of POEM for patients with achalasia. METHODS: POEM was...

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Detalles Bibliográficos
Autores principales: Lee, Byung Hoo, Shim, Kwang Yeun, Hong, Su Jin, Bok, Gene Hyun, Cho, Jun-Hyung, Lee, Tae Hee, Cho, Joo Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Gastrointestinal Endoscopy 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630310/
https://www.ncbi.nlm.nih.gov/pubmed/23614126
http://dx.doi.org/10.5946/ce.2013.46.2.161
Descripción
Sumario:BACKGROUND/AIMS: Achalasia is a rare esophageal motility disorder. Recently, a novel endoscopic technique, peroral endoscopic myotomy (POEM), was introduced as an alternative treatment for achalasia. We report the results and short term outcomes of POEM for patients with achalasia. METHODS: POEM was performed in 13 patients with achalasia. The procedure consisted of creating a submucosal tunnel followed by endoscopic myotomy of circular muscle bundles. The mucosal entry was closed by conventional hemostatic clips. A validated clinical symptom score (Eckardt score) and high resolution manometry were used to evaluate the outcomes. RESULTS: Both the clinical score of achalasia, as well as the resting lower esophageal sphincter (LES) pressure, were significantly reduced after POEM. Mean posttreatment Eckardt score was 0.4±0.7, compared to 6.4±1.9 prior to the treatment (p=0.001). The mean pretreatment and posttreatment LES pressure was 30.3 and 15.3 mm Hg, respectively (p=0.007). Following POEM, symptomatic relief from dysphagia without reflux symptoms was observed in all patients (13/13). No serious complications related to POEM were encountered. CONCLUSIONS: Based upon our initial experience, the authors believe that POEM is a feasible, safe, and effective treatment and may possibly substitute established treatments of refractory achalasia.