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Peroral endoscopic myotomy

Tessa Verlaan, Fraukje A M Ponds, Barbara A J Bastiaansen, Albert J Bredenoord, Paul Fockens
: Background and aims: After Peroral Endoscopic Myotomy (POEM), the mucosal incision is closed with endoscopically applied clips. After each clip placement, a subsequent clipping device has to be introduced through the working channel. With the Clipmaster3, three consecutive clips can be placed without reloading which could reduce closure time. We performed a prospective study evaluating efficacy, safety, and ease of use. Closure using Clipmaster3 was compared to closure with standard clips...
October 2016: Endoscopy International Open
Oscar Víctor Hernández-Mondragón, Omar Michel Solórzano-Pineda, Gerardo Blanco-Velasco, Juan Manuel Blancas-Valencia
No abstract text is available yet for this article.
January 2016: Endoscopy
N Nakajima, H Sato, K Takahashi, G Hasegawa, K Mizuno, S Hashimoto, Y Sato, S Terai
BACKGROUND: Histopathology of muscularis externa in primary esophageal motility disorders has been characterized previously. We aimed to correlate the results of high-resolution manometry with those of histopathology. METHODS: During peroral endoscopic myotomy, peroral esophageal muscle biopsy was performed in patients with primary esophageal motility disorders. Immunohistochemical staining for c-kit was performed to assess the interstitial cells of Cajal (ICCs)...
October 3, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Helle Ø Kristensen, Jakob Kirkegård, Daniel Willy Kjær, Frank Viborg Mortensen, Rastislav Kunda, Niels Christian Bjerregaard
BACKGROUND: Peroral endoscopic myotomy (POEM) is an emerging procedure in the treatment of esophageal achalasia, a primary motility disorder. However, the long-term outcome of POEM in patients, who have previously undergone a Heller myotomy, is unknown. METHODS: Using a local database, we identified patients with esophageal achalasia, who underwent POEM. We compared patients with a previous Heller myotomy to those, who had received none or only non-surgical therapy prior to the POEM procedure...
October 3, 2016: Surgical Endoscopy
Tsung-Shih Li, Tsung-Yang Lee, Kate Hsiurong Liao
More and more endoscopically gastrointestinal procedures require anesthesiologists to perform general anesthesia, such as "peroral endoscopic myotomy". Peroral endoscopic myotomy is a novel invasive treatment for the primary motility disorder of esophagus, called esophageal achalasia. Despite of its minimally invasive feature, there are still complications during the procedure which develop to critical conditions and threat patients' lives. Herein we describe a case about tension pneumothorax subsequent to esophageal rupture during peroral endoscopic myotomy...
September 27, 2016: Revista Brasileira de Anestesiologia
An Moonen, Guy Boeckxstaens
Achalasia is a primary esophageal motor disorder of the esophagus that is characterized by the absence of esophageal peristalsis and a failure of the lower esophageal sphincter (LES) to relax upon swallowing. The defective relaxation leads to symptoms of dysphagia for solids and liquids, regurgitation, aspiration, chest pain, and weight loss. Achalasia is believed to result from a selective loss of enteric inhibitory neurons, most likely due to an autoimmune phenomenon in genetic susceptible individuals. As there is no curative treatment for achalasia, treatment is confined to disruption of the LES to improve bolus passage...
September 29, 2016: Current Treatment Options in Gastroenterology
Yuyong Tan, Deliang Liu, Jirong Huo
No abstract text is available yet for this article.
October 2016: Endoscopy
Xuehong Wang, Yuyong Tan, Liang Lv, Hongyi Zhu, Yi Chu, Chenjie Li, Deliang Liu
BACKGROUND AND AIM: Both peroral endoscopic myotomy (POEM) and pneumatic dilation (PD) has proved to be effective for treating achalasia in patients aged ≥ 65 years. However little is known about the comparison between POEM and PD. The aim of the study was to compare the safety and efficacy of POEM and PD for the treatment of achalasia in these patients. METHODS: We retrospectively reviewed the medical records of patients aged 65 years-old or more who received POEM or PD for the treatment of achalasia at our hospital from January 2010 to December 2015, they were divided into the POEM group and the PD group...
October 2016: Revista Española de Enfermedades Digestivas
Oscar M Crespin, Louis W C Liu, Ambica Parmar, Timothy D Jackson, Jemila Hamid, Eran Shlomovitz, Allan Okrainec
INTRODUCTION: Peroral endoscopic myotomy (POEM) is a novel intervention for the treatment of achalasia, which combines the advantages of endoscopic access and myotomy. The purpose of this study was to perform a systematic review of the literature to evaluate the efficacy and safety of POEM. METHODS: The systematic review was conducted following the PRISMA guidelines. Evidence-Based Medicine Reviews, Cochrane Central Register of Controlled Trials, Ovid MEDLINE (R) including in-process and non-indexed citations were searched for POEM studies using the keywords: esophageal achalasia, POEM, endoscopy, natural orifice surgery, laparoscopic Heller myotomy (LHM), and related terms...
September 15, 2016: Surgical Endoscopy
Madhusudhan R Sanaka, Ramprasad Jegadeesan, Prashanthi N Thota, Udayakumar Navaneethan, Rocio Lopez, Sudish C Murthy, Siva Raja
Background and Aims. We initiated peroral endoscopic myotomy (POEM) utilizing a two-person technique with combination of an advanced endoscopist and a thoracic surgeon with complementary skills. Our aim was to determine the feasibility and outcomes in initial 20 patients. Methods. In this observational study, main outcomes measured were therapeutic success in relieving symptoms (Eckardt score < 3), decrease in lower esophageal sphincter (LES) pressures, improvement in emptying on timed barium esophagogram (TBE), and complications...
2016: Canadian Journal of Gastroenterology & Hepatology
Nithin Jayan, Jaya Susan Jacob, Mohan Mathew, Roy Joy Mukkada
BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is a safe and minimally invasive modality regarded as the first-line management of all types of achalasia. POEM is performed under general anesthesia with endotracheal intubation using an orally inserted flexible fiberscope. The aim of this study is to describe the anesthetic management of POEM for achalasia. MATERIAL AND METHODS: A chart review of 21 patients who underwent POEM for achalasia at our center from March 2013 to June 2015 was performed...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Stavros N Stavropoulos, David Friedel, Rani Modayil, Henry P Parkman
Achalasia is a rare esophageal motility disorder that is usually idiopathic in origin. It is characterized by dysphagia, and patients often have chest pain, regurgitation, weight loss, and an abnormal barium radiograph showing esophageal dilation with narrowing at the gastroesophageal junction. Abnormal or absent esophageal peristalsis and impaired relaxation of the lower esophageal sphincter (LES) are typically seen on esophageal manometry. The advent of high resolution manometry (HRM) has allowed more precise diagnosis of achalasia, subtype designation, and differentiation from other esophageal motor disorders with an initial seminal publication in 2008 followed by further refinements of what has been termed the Chicago classification...
September 13, 2016: BMJ: British Medical Journal
Emmanuel Akintoye, Nitin Kumar, Itegbemie Obaitan, Quazim A Alayo, Christopher C Thompson
Background and study aim: Peroral endoscopic myotomy (POEM) is a relatively novel minimally invasive technique that is used to treat achalasia and other esophageal motility disorders. We systematically reviewed the medical literature in order to evaluate the safety and efficacy of POEM. Methods: We performed a comprehensive review and meta-analysis of studies published up to March 2016 that reported on clinical outcomes of POEM. Five databases were searched: MEDLINE, EMBASE, Ovid, CINAHL, and Cochrane. Results: A total of 36 studies involving 2373 patients were included in the review...
September 12, 2016: Endoscopy
Majidah Bukhari, Vivek Kumbhari, Yamile Haito-Chavez, Yen-I Chen, Saowanee Ngamruengphong, Payal Saxena, Mouen A Khashab
No abstract text is available yet for this article.
2016: Endoscopy
Xiao-Cen Zhang, Quan-Lin Li, Mei-Dong Xu, Shi-Yao Chen, Yun-Shi Zhong, Yi-Qun Zhang, Wei-Feng Chen, Li-Li Ma, Wen-Zheng Qin, Jian-Wei Hu, Ming-Yan Cai, Li-Qing Yao, Ping-Hong Zhou
Background and study aims: Peroral endoscopic myotomy (POEM) is now a widely used treatment for esophageal achalasia, supported by several large cohort studies. Although major perioperative adverse events (mAE) are rare, in-depth investigations of related risks and preventive measures are lacking. The aim of this study was to systematically assess mAEs during POEM by analyzing their incidence, risks, prevention, and management. Patients and methods: This retrospective single-center analysis included all patients (n = 1680) undergoing POEM between August 2010 and July 2015 at Zhongshan Hospital...
July 22, 2016: Endoscopy
Xiao-Bing Ma, En-Qiang Linghu, Hui-Kai Li, Ya-Qi Zhai, Ning-Li Chai, Li-Hua Peng, Xiang-Dong Wang, Hong DU, Jiang-Yun Meng, Hong-Bin Wang, Jing Zhu, Ming-Zhou Guo, Xiao-Xiao Wang, Zhong-Sheng Lu
OBJECTIVE: To identify the factors that affect the safety and efficacy of peroral endoscopic myotomy (POEM) for treatment of achalasia. METHODS: Data of consecutive patients undergoing POEM for confirmed achalasia between December, 2010 and December, 2015 were collected, including the procedure time, approach of tunnel entry incision, approach of myotomy, complications and follow-up data. RESULTS: Among the total of 439 patients enrolled, the overall complication rate was 28...
June 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Felice Schnoll-Sussman, Philip O Katz
Esophageal dysphagia in the elderly is a common clinical problem. Achalasia is a disease in which there is loss of ganglion in the myenteric plexus of the lower esophageal sphincter resulting in incomplete relaxation of that muscle causing a functional obstruction to outflow. Treatment is aimed at reducing sphincter pressure allowing for gravity and the oral portion of the swallow to propel the bolus through the esophagus. Pneumatic dilatation, Heller myotomy (laparoscopic), and the newest procedure peroral endoscopic esophageal myotomy (POEM) are all reasonable options for effective treatment even in the elderly...
September 2016: Current Treatment Options in Gastroenterology
Mouen A Khashab, Saowanee Ngamruengphong, David Carr-Locke, Amol Bapaye, Petros C Benias, Sam Serouya, Shivangi Dorwat, Dalton M Chaves, Everson Artifon, Eduardo G de Moura, Vivek Kumbhari, Yamile Haito Chavez, Majidah Bukhari, Gulara Hajiyeva, Amr Ismail, Yen-I Chen, Hyunsoo Chung
BACKGROUND AND AIMS: Gastric peroral endoscopic myotomy (G-POEM) has been recently reported as minimally invasive therapy for gastroparesis. The aims of this study were to report the first multicenter experience with G-POEM and assess the efficacy and safety of this novel procedure for gastroparetic patients with symptoms refractory to medical therapy. PATIENTS AND METHODS: All patients with gastroparesis who underwent endoscopic pyloromyotomy (G-POEM) at 5 medical centers were included...
June 25, 2016: Gastrointestinal Endoscopy
Yuyong Tan, Hongyi Zhu, Chenjie Li, Yi Chu, Jirong Huo, Deliang Liu
BACKGROUND: Both peroral endoscopic myotomy (POEM) and endoscopic balloon dilation (EBD) are effective method for pediatric achalasia, however little is known about the comparison between them. Herein we compare the safety and efficacy of them for primary treatment of pediatric achalasia. METHODS: We retrospectively reviewed the medical records of pediatric patients who received POEM or EBD for their primary therapy of achalasia at our hospital from January 2007 to June 2015, they were divided into the POEM group and EBD group...
October 2016: Journal of Pediatric Surgery
Guy E Boeckxstaens
Achalasia is a primary esophageal motility disorder with an estimated annual incidence of 1 per 100,000 persons. It is characterized by the absence of esophageal peristalsis and failure of the lower esophageal sphincter (LES) to relax upon swallowing, resulting in progressively severe dysphagia for solids and liquids, regurgitation, aspiration, chest pain and weight loss. Achalasia results from a loss of enteric neurons, most likely due to an autoimmune reaction in patients with a particular immunogenetic background...
2016: Digestive Diseases
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