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Peroral endoscopic myotomy

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https://www.readbyqxmd.com/read/28717439/achalasia-current-therapeutic-options
#1
REVIEW
Zubin Arora, Prashanthi N Thota, Madhusudhan R Sanaka
Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia...
June 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/28711287/in-vivo-experience-with-poem-an-essential-activity-for-developing-the-technique-in-humans
#2
A Peñaloza-Ramírez, J Suárez-Correa, J Báez-Blanco, C Sabogal-Gómez, H Kuan-Casas, C Sánchez-Pignalosa, P Aponte-Ordóñez
INTRODUCTION AND OBJECTIVES: Achalasia is the most widely studied esophageal motility disorder. No treatment has achieved completely satisfactory results. The laparoscopic Heller esophagomyotomy is currently the most accepted technique. With the advent of minimally invasive surgery, the appearance of peroral endoscopic submucosal myotomy (POEM) has promising results. The primary aim of our study was to perform peroral endoscopic esophagomyotomy in animal experimentation models to perfect the technique and later apply it to humans...
July 12, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28707343/peroral-endoscopic-myotomy-is-safe-and-effective-in-achalasia-patients-aged-older-than-60%C3%A2-years-compared-with-younger-patients
#3
Xiaowei Tang, Yutang Ren, Qiaoping Gao, Silin Huang, Jieqiong Zhou, Xiaofeng Zhang, Jianfeng Yang, Zhengjie Wei, Zhenyu Chen, Bo Jiang, Wei Gong
AIM: Peroral endoscopic myotomy (POEM) has been proven to be effective for treating achalasia, but there are limited data on POEM in elderly patients. We therefore aimed to assess the role of POEM for achalasia in patients aged ≥60 years. METHODS: All consecutive patients that underwent POEM between December 2011 and November 2015 at a single center were retrospectively reviewed. Patients aged ≥60 years were assigned to group A, whereas patients aged <60 years were assigned to group B...
July 14, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28691974/peroral-endoscopic-myotomy-in-children-with-achalasia-a-relatively-long-term-single-center-study
#4
Miao Shijian, Wu Jie, Lu Junping, Wang Yuhuan, Tang Zifei, Zhou Ying, Huang Zhiheng, Ying Huang, Zhou Pinghong
BACKGROUND: Achalasia is a disease caused by neuromuscular dysfunction in the esophagogastric junction, with a relatively low incidence among children. Peroral endoscopic myotomy (POEM) is a new endoscopic procedure for the treatment of achalasia, however it is rarely applied in children. OBJECTIVES: We aim to study the feasibility, safety, and effectiveness of POEM as a treatment for pediatric achalasia. METHODS: A total of 21 pediatric patients (aged from 11 months to 18 years) diagnosed with achalasia and treated with POEM from October of 2014 to October of 2016 in our hospital were included in our study...
July 6, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28691051/peroral-endoscopic-myotomy-using-flushknife-bt-a-single-center-series
#5
Shinwa Tanaka, Takashi Toyonaga, Fumiaki Kawara, Ian S Grimm, Namiko Hoshi, Hirofumi Abe, Yoshiko Ohara, Yoshinori Morita, Eiji Umegaki, Takeshi Azuma
BACKGROUND AND STUDY AIMS : Peroral endoscopic myotomy (POEM) is an evolving new treatment strategy for achalasia. Although several kinds of electrosurgical knives have been used in performing POEM, the best device has yet to be determined. The FlushKnife BT is a waterjet-emitting short needle-knife with a small ball tip (BT) that offers the potential to perform all aspects of POEM with a single device. In this study, we evaluated the safety and efficiency of the FlushKnife BT for POEM...
July 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28686741/correction-functional-restoration-of-the-esophagus-after-peroral-endoscopic-myotomy-for-achalasia
#6
Cheal Wung Huh, Young Hoon Youn, Hyunsoo Chung, Yong Chan Lee, Hyojin Park
[This corrects the article DOI: 10.1371/journal.pone.0178414.].
2017: PloS One
https://www.readbyqxmd.com/read/28664434/clinical-outcomes-five-years-after-poem-for-treatment-of-primary-esophageal-motility-disorders
#7
Ezra N Teitelbaum, Christy M Dunst, Kevin M Reavis, Ahmed M Sharata, Marc A Ward, Steven R DeMeester, Lee L Swanström
BACKGROUND: Peroral endoscopic myotomy (POEM) is a novel operation for the treatment of achalasia and other esophageal motility disorders. While POEM has shown excellent short-term safety and efficacy, the long-term symptomatic outcomes after the procedure are unknown. METHODS: Patients from a single center that underwent POEM for treatment of esophageal motility orders and were greater than 5 years removed from their operation were studied. Patients were contacted to assess current symptoms and encouraged to undergo repeat endoscopy for objective follow-up...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28658695/-french-comment-on-article-gastroesophageal-reflux-after-peroral-endoscopic-myotomy-a-multicenter-case-control-study1
#8
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Endoscopy
https://www.readbyqxmd.com/read/28658680/submucosal-fibrosis-in-achalasia-patients-is-a-rare-cause-of-aborted-peroral-endoscopic-myotomy-procedures
#9
Qiu-Ning Wu, Xiao-Yue Xu, Xiao-Cen Zhang, Mei-Dong Xu, Yi-Qun Zhang, Wei-Feng Chen, Ming-Yan Cai, Wen-Zheng Qin, Jian-Wei Hu, Li-Qing Yao, Quan-Lin Li, Ping-Hong Zhou
Background and aims Peroral endoscopic myotomy (POEM) is now an established treatment for esophageal achalasia. The standard protocol ensures a smooth operation in most patients, but technical challenges and failures exist and little is known about the incidence, causes, and impact of aborted procedures. Here, using a large patient cohort, we attempted to answer these questions. Methods All patients admitted for planned POEM between August 2010 and July 2015 underwent chart review. Aborted POEM was defined as the inability to finish the procedure after submucosal injection...
June 28, 2017: Endoscopy
https://www.readbyqxmd.com/read/28657822/health-related-quality-of-life-and-physiological-outcomes-of-peroral-endoscopic-myotomy-for-achalasia
#10
Jacob J Benedict, Adam A Golas, Joel E Richter, Vic Velanovich
BACKGROUND: Peroral endoscopic myotomy (POEM) has gained acceptance as a treatment for achalasia. The aim of this study was to assess symptomatic, quality of life (QoL), and physiological outcomes of POEM using standardized methods. MATERIALS AND METHODS: Patients who were planned to undergo POEM were evaluated pre- and postoperatively with timed barium esophagogram (TBE), high-resolution manometry (HRM), the achalasia symptom questionnaire (ASQ) (best score 10, worst score 31), and the short form (SF)-36 (best score 100, worst score 0)...
June 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28656335/gentamicin-submucosal-lavage-during-peroral-endoscopic-myotomy-poem-a-retrospective-analysis
#11
Julia Bayer, Zuzana Vackova, Hana Svecova, Petr Stirand, Julius Spicak, Jan Martinek
BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is an evolving therapeutic modality for achalasia. According to the original Inoue's technique, a submucosal lavage with gentamicin has been practiced due to the fear of infection. This single-tertiary center study was intended to assess the clinical significance of the topical antibiotic lavage during POEM. METHODS: A retrospective analysis of prospectively collected data was conducted. The outcomes of patients who received the gentamicin lavage (group A) during POEM were compared to those who did not (group B)...
June 27, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28651308/comparison-of-the-outcomes-of-peroral-endoscopic-myotomy-for-achalasia-according-to-manometric-subtype
#12
Won Hee Kim, Joo Young Cho, Weon Jin Ko, Sung Pyo Hong, Ki Baik Hahm, Jun-Hyung Cho, Tae Hee Lee, Su Jin Hong
Background/Aims: We evaluated whether manometric subtype is associated with treatment outcome in patients with achalasia treated by peroral endoscopic myotomy (POEM). Methods: High-resolution manometry data and Eckardt scores were collected from 83 cases at two tertiary referral centers where POEM is performed. Manometric tracings were classified according to the three Chicago subtypes. Results: Among the 83 cases, 48 type I, 24 type II, and 11 type III achalasia cases were identified...
June 27, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28617890/peroral-endoscopic-myotomy-for-the-treatment-of-achalasia-in-a-patient-with-esophageal-varices-a-case-report
#13
Naning Shen, Xin Wang, Xiaoyin Zhang, Liping Yao, Huahong Xie, Hongbo Zhang
Achalasia is very uncommon, and rarely does achalasia co-exist with esophageal varices. We present a 62-year-old woman who was diagnosed with both achalasia and esophageal varices in December 2014 and had a past history of hematemesis. The patient's achalasia symptoms' Eckardt score was 9, and her hepatic function was Child-Pugh grade A6. After comprehensive assessment of the patient's health and discussion of the pros and cons of various therapies for achalasia, the patient underwent a peroral endoscopic myotomy...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28617027/efficacy-of-peroral-endoscopic-myotomy-compared-with-other-invasive-treatment-options-for-the-different-esophageal-motor-disorders
#14
Fermín Estremera-Arévalo, Eduardo Albéniz, María Rullán, Irene Areste, Rosa Iglesias, Juan José Vila
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been performed since 2008 on more than 5,000 patients. It has proven to be highly effective in the treatment of achalasia and has shown promising outcomes for other esophageal motility spastic disorders. METHODS: A literature review of the efficacy of POEM compared to the previous invasive treatments for different esophageal motility disorders was performed. The application in the pediatric and elderly populations and its role as a rescue therapy after other procedures are also outlined...
June 15, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28616407/peroral-endoscopic-myotomy-poem-for-treating-esophageal-motility-disorders
#15
REVIEW
Ian Wong, Simon Law
Pneumatic dilatation and Heller myotomy have been thoroughly studied as the most viable treatment options for achalasia. The pendulum, however, is shifting to the minimally invasive approach. Since Inoue et al. published the experience of the first 17 cases of peroral endoscopic myotomy (POEM) in 2010, there have been at least 5,000 cases performed worldwide and the number is increasing exponentially. Experts across the globe have been extending the indications to various esophageal motility disorders, to patients of extremes of age, sigmoidal esophagus and re-operated patients...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28616397/development-and-use-of-a-non-biomaterial-model-for-hands-on-training-of-endoscopic-procedures
#16
Hiroki Sato, Ken-Ichi Mizuno, Yuichi Sato, Satoru Hashimoto, Kazunao Hayashi, Satoshi Ikarashi, Yutaka Honda, Junji Yokoyama, Shuji Terai
BACKGROUND: Endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM) are recently developed techniques that have the potential to significantly improve clinical outcomes. However, training opportunities on these techniques remain limited. To address this issue, we developed a novel ex-vivo ESD/POEM training model. Our aim in this paper is to describe the model and provide preliminary evidence of promising feasibility to improve access to ESD/POEM training. METHODS: The model was developed using polyvinyl alcohol hydrogel, which can easily be modified to reproduce the stiffness of the different intestinal layers, namely the mucosa, submucosa, and muscle layer...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28575245/peroral-endoscopic-myotomy-versus-surgical-myotomy-for-primary-achalasia-single-center-retrospective-analysis-of-74-patients
#17
S de Pascale, A Repici, F Puccetti, E Carlani, R Rosati, U Fumagalli
Achalasia is a neurodegenerative motility disorder of the esophagus; dysphagia, weight loss, chest pain, and regurgitation are its main symptoms. Surgical myotomy (HM) is considered the gold standard treatment. However, peroral endoscopic myotomy (POEM) seems to be a safe and effective alternative option. The aim of this study is to compare the safety and efficacy of these techniques. From March 2012 to June 2015, 74 patients with symptomatic primary achalasia underwent myotomy. The two groups were compared in terms of intraoperative and postoperative outcomes and Eckardt score at last follow-up...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28566891/ling-classification-describes-endoscopic-progressive-process-of-achalasia-and-successful-peroral-endoscopy-myotomy-prevents-endoscopic-progression-of-achalasia
#18
Wen-Gang Zhang, En-Qiang Linghu, Ning-Li Chai, Hui-Kai Li
AIM: To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy (POEM) to prevent endoscopic progression of achalasia. METHODS: We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients (197 women, 162 men) with a mean age of 42.1 years (range, 12-75 years) were evaluated...
May 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28557560/a-retrospective-study-of-peroral-endoscopic-full-thickness-myotomy-in-patients-with-severe-achalasia
#19
Tianying Duan, Yuyong Tan, Junfeng Zhou, Liang Lv, Deliang Liu
OBJECTIVES: Selective circular myotomy (CM) is recommended in peroral endoscopic myotomy (POEM) for achalasia, but completeness of myotmoy is the prerequisite for excellent long-term results of conventional surgical myotomy. The aim of our study was to compare the efficacy and safety between peroral endoscopic full-thickness and simple CM for the treatment of severe achalasia. MATERIALS AND METHODS: A total of 123 severe achalasia patients who underwent POEM from August 2011 to May 2013 were included...
May 30, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28549006/laparoscopic-heller-myotomy-versus-peroral-endoscopic-myotomy-poem-for-achalasia-a-systematic-review-and-meta-analysis
#20
Francisco Schlottmann, Daniel J Luckett, Jason Fine, Nicholas J Shaheen, Marco G Patti
OBJECTIVE: To compare the outcome of per oral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) for the treatment of esophageal achalasia. BACKGROUND: Over the last 2 decades, LHM has become the primary form of treatment in many centers. However, since the first description of POEM in 2010, this technique has widely disseminated, despite the absence of long-term results and randomized trials. METHODS: A systematic Medline literature search of articles on LHM and POEM for the treatment of achalasia was performed...
May 25, 2017: Annals of Surgery
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