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Peroral endoscopic myotomy

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https://www.readbyqxmd.com/read/28528063/an-involuntary-and-unexpected-treatment-of-nutcracker-esophagus
#1
Diane Mege, Alban Benezech, Henri de Lesquen, Véronique Vitton, Pascal-Alexandre Thomas
A 76-year-old woman complained of painful dysphagia and loss of weight. Esophagoscopy results were negative, whereas computed tomography (CT) disclosed a 25-mm mediastinal tumor without a connection to the esophagus. A diagnosis of nutcracker esophagus was made on high-resolution esophageal manometry. Peroral endoscopic esophageal myotomy failed to improve the symptoms. Right video thoracoscopy allowed resection of the tumor, which looked like a neurogenic tumor of the posterior mediastinum that developed from the right vagus nerve...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28472834/gastroesophageal-reflux-after-peroral-endoscopic-myotomy-a-multicenter-case-control-study
#2
Vivek Kumbhari, Pietro Familiari, Niels Christian Bjerregaard, Mathieu Pioche, Edward Jones, Weon Jin Ko, Bu Hayee, Anna Cali, Saowanee Ngamruengphong, Francois Mion, Ruben Hernaez, Sabine Roman, Alan H Tieu, Mohamad El Zein, Tokunbo Ajayi, Amyn Haji, Joo Young Cho, Jeffrey Hazey, Kyle A Perry, Thierry Ponchon, Rastislav Kunda, Guido Costamagna, Mouen A Khashab
Background and study aims The variables associated with gastroesophageal reflux (GER) after peroral endoscopic myotomy (POEM) are largely unknown. This study aimed to: 1) identify the prevalence of reflux esophagitis and asymptomatic GER in patients who underwent POEM, and 2) evaluate patient and intraprocedural variables associated with post-POEM GER. Patients and methods All patients who underwent POEM and subsequent objective testing for GER (pH study with or without upper gastrointestinal [GI] endoscopy) at seven tertiary academic centers (one Asian, two US, four European) were included...
May 4, 2017: Endoscopy
https://www.readbyqxmd.com/read/28472017/systematic-review-and-meta-analysis-of-perioperative-outcomes-of-peroral-endoscopic-myotomy-poem-and-laparoscopic-heller-myotomy-lhm-for-achalasia
#3
Aiman Awaiz, Rossita M Yunus, Shahjahan Khan, Breda Memon, Muhammed A Memon
AIMS AND OBJECTIVES: Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM. MATERIALS AND METHODS: A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, and current contents for English-language articles comparing LHM and POEM between 2007 and 2016 was performed...
May 3, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28464200/submucosal-tunneling-endoscopic-septum-division-for-zenker-s-diverticulum-a-reproducible-procedure-for-endoscopists-who-perform-peroral-endoscopic-myotomy
#4
Bertrand Brieau, Sarah Leblanc, Benoit Bordacahar, Maximillien Barret, Romain Coriat, Frederic Prat, Stanislas Chaussade
No abstract text is available yet for this article.
May 2, 2017: Endoscopy
https://www.readbyqxmd.com/read/28426463/treatments-for-achalasia-in-2017-how-to-choose-among-them
#5
Peter J Kahrilas, John E Pandolfino
PURPOSE OF REVIEW: To review recent advances in achalasia diagnostics and therapeutics. RECENT FINDINGS: The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]...
April 19, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28417135/a-training-model-for-introducing-a-novel-surgical-procedure-into-clinical-practice-our-experience-on-peroral-endoscopic-myotomy-for-achalasia
#6
Dedrick Kh Chan, Reuben Km Wong, Janelle Ns Phua, Asim Shabbir, Khek Yu Ho, Philip Wy Chiu, Jimmy By So
No abstract text is available yet for this article.
March 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28411346/peroral-endoscopic-myotomy-compared-with-pneumatic-dilation-for-newly-diagnosed-achalasia
#7
Fandong Meng, Peng Li, Yongjun Wang, Ming Ji, Yongdong Wu, Li Yu, Yinglin Niu, Fujing Lv, Wei Li, Wenyan Li, Huihong Zhai, Shanshan Wu, Shutian Zhang
BACKGROUND: This study retrospectively compared the safety and efficacy of two endoscopic techniques for treating newly diagnosed achalasia, pneumatic dilation (PD), and peroral endoscopic myotomy (POEM). METHODS: Demographics, clinical and manometric data, and outcomes were collected from the medical records of patients who received POEM or PD as the primary therapy for achalasia at our hospital from January 2012 to August 2015. RESULTS: Of 72 patients, 32 and 40 received POEM and PD, respectively...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28375443/long-term-outcomes-of-peroral-endoscopic-myotomy-for-patients-with-achalasia-a-retrospective-single-center-study
#8
H Guo, H Yang, X Zhang, L Wang, Y Lv, X Zou, T Ling
Peroral endoscopic myotomy (POEM) has been widely applied to the treatment of achalasia. The aim of this study is to retrospectively investigate the long-term outcome of POEM in patients with achalasia. Patients undergoing POEM at our center with a minimum follow-up of 3 years were enrolled in this study. Relief of patients' symptom was defined as the primary outcome. Secondary outcomes included lower esophageal sphincter pressure, esophageal emptying, symptoms relapse, and clinical reflux adverse events. The Chi-square test was performed to determine the potential predictors of surgical failure...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28374443/the-applications-of-poem-for-special-patient-cohorts-a-review
#9
REVIEW
Dan Mu, Yue Yue Li, Ming Ming Zhang, Yan Zhang, Zhen Li, Yan Qing Li
Peroral endoscopic myotomy (POEM) is a relatively mini-invasive technique which can perform endoscopic myotomy by establishing a submucosal tunnel, and it has been firstly applied in animals since 2007.(1).
April 4, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28361839/peroral-endoscopic-myotomy-achieves-similar-clinical-response-but-incurs-lesser-charges-compared-to-robotic-heller-myotomy
#10
Mouen A Khashab, Vivek Kumbhari, Alan H Tieu, Mohamad H El Zein, Amr Ismail, Saowanee Ngamruengphong, Vikesh K Singh, Anthony N Kalloo, John O Clarke, Ellen M Stein
BACKGROUND/AIM: Several uncontrolled studies comparing peroral endoscopic myotomy (POEM) and Heller myotomy have demonstrated equivalent short-term efficacy and safety. However, no data exists rergarding the cost of POEM and how it compares to that of robotic Heller myotomy (RHM). The primary aim of this study was to compare the inpatient charges incurred in patients who underwent POEM or RHM for the treatment of achalasia. PATIENTS AND METHODS: A retrospective single center review was conducted among 52 consecutive POEM patients (2012-2014) and 52 consecutive RHM patients (2009-2014)...
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28321165/fibrin-sealant-for-closure-of-mucosal-penetration-at-the-cardia-during-peroral-endoscopic-myotomy-a-retrospective-study-at-a-single-center
#11
Wen-Gang Zhang, En-Qiang Linghu, Hui-Kai Li
AIM: To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy (POEM). METHODS: Twenty-four patients who underwent POEM and experienced mucosal injury of the cardia during the procedure were retrospectively identified. Of the 24 patients, 21 had mucosal penetration and 3 had only slight mucosal damage without penetration. The 21 patients with mucosal penetration received fibrin sealant for closure at the site of penetration...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28316620/clinical-outcomes-and-safety-of-partial-full-thickness-myotomy-versus-circular-muscle-myotomy-in-peroral-endoscopic-myotomy-for-achalasia-patients
#12
Chenyu Li, Aixia Gong, Jingwen Zhang, Zhijun Duan, Linmei Ge, Nan Xia, Jing Leng, Mei Li, Yanjie Liu
Background. Here we aimed to evaluate and compare the efficacy and safety between partial full-thickness myotomy and circular muscle myotomy during POEM procedure in achalasia patients. Methods. Clinical data of achalasia of cardia (AC) patients who underwent POEM in our center during January 2014 to January 2015 was collected (34 cases). 19 patients who received partial full-thickness myotomy were assigned to group A and 14 patients who received circular muscle myotomy were assigned to group B. The procedure-related parameters between the two groups were compared...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28315151/peroral-endoscopic-myotomy-for-type-iii-achalasia-of-chicago-classification-outcomes-with-a-minimum-follow-up-of-24%C3%A2-months
#13
Wengang Zhang, En-Qiang Linghu
INTRODUCTION: There are only few studies about the outcomes of peroral endoscopic myotomy (POEM) for type III achalasia in a relatively large population to date. The purpose of this study was to explore the long-term efficacy of POEM for patients with type III achalasia. METHODS: There were a total of 32 consecutive patients with type III achalasia undergoing POEM in our hospital from July 2012 to October 2014. Clinical date of general characteristics, procedure-related parameters and adverse events, symptom relief, and the high-resolution manometry outcomes before and during the periodic follow-up were retrospectively collected and analyzed...
May 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28260955/peroral-endoscopic-myotomy-procedural-complications-and-pain-management-for-the-perioperative-clinician
#14
Lopa Misra, Norio Fukami, Katarina Nikolic, Terrence L Trentman
Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM) in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28250904/combination-of-concurrent-endoscopic-submucosal-dissection-and-modified-peroral-endoscopic-myotomy-for-an-achalasia-patient-with-synchronous-early-esophageal-neoplasms
#15
Sha Shi, Kuangi Fu, Xin-Qian Dong, Yu-Jing Hao, Sen-Lin Li
Achalasia is generally accepted as a condition associated with an increased risk for developing esophageal squamous cell carcinoma. In our paper, we introduced an achalasia patient combined with synchronous early esophageal neoplasms. We performed a combination of concurrent endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM). No complications other than postoperative pain that needed morphine treatment for two days had occurred. Dysphagia was significantly improved. Neither reflux nor cough occurred...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28243108/successful-peroral-endoscopic-myotomy-performed-in-endoscopy-department-as-a-radical-long-term-treatment-for-esophageal-achalasia-the-greek-experience
#16
Nikolas Eleftheriadis, Eleni Damianos Eleftheriadou
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been considered as a minimal-invasive, innovative technique for long-term treatment of all types of esophageal achalasia and other esophageal motility disorders. PATIENTS AND METHODS: We report on 20 consecutive Greek patients with manometrically proved esophageal achalasia (14 patients with type I, 4 with type II, 2 with type III, and 4 with sigmoid esophagus), with an age range of 32-92 years, mean age 59 years, 12 males, successfully treated by POEM from 2013 to 2015...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28223738/peroral-endoscopic-myotomy-for-treatment-of-guillain-barre-syndrome-associated-achalasia-a-rare-case
#17
Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park
Guillain-Barre syndrome (GBS)-associated achalasia is a very rare disease of uncertain cause. We report the case of a patient diagnosed with GBS-associated type I achalasia who was successfully treated with peroral endoscopic myotomy (POEM). A 30-year-old man who was diagnosed with GBS 3 mo before was referred to our department with dysphagia and meal-related regurgitation. The results of esophagography, endoscopy, and high-resolution manometry (HRM) revealed type I achalasia. POEM that utilized a submucosal tunneling technique was performed to treat the GBS-associated type I achalasia...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28148574/peroral-endoscopic-myotomy-a-literature-review-and-the-first-uk-case-series
#18
Shraddha Gulati, Andrew Emmanuel, Haruhiro Inoue, Bu'Hussain Hayee, Amyn Haji
Peroral endoscopic myotomy (POEM) is an established treatment for primary achalasia. It has gained endorsement from the American Society for Gastrointestinal Endoscopy with increasing clinical acceptance since the first procedure, performed in Japan in 2008. The first successful POEM in the UK was performed in November 2013 at King's College Hospital and this article presents the first UK case series. Prospective data were collected at 3 and 12-24 months for consecutive patients undergoing POEM. Post-POEM gastro-oesophageal reflux health-related quality of life scale (GORD-HRQoL) score was recorded...
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28145968/outcome-of-peroral-endoscopic-myotomy-poem-for-treating-achalasia-compared-with-laparoscopic-heller-myotomy-lhm
#19
Lijun Peng, Shuni Tian, Chao Du, Ziying Yuan, Mingxiao Guo, Lin Lu
OBJECTIVE: Peroral endoscopic myotomy (POEM) is an emerging endoscopic treatment for achalasia and the long-term efficacy of POEM remains to be evaluated. This study compared the outcomes of POEM with that of the standard laparoscopic Heller myotomy (LHM) for achalasia. MATERIALS AND METHODS: Achalasia patients treated by POEM or LHM were retrospectively analyzed, with a minimum postoperative follow-up of 3 years. Perioperative outcomes and long-term outcomes including treatment success (Eckardt score ≤3), occurrence of gastroesophageal reflux disease (GERD) (GerdQ score ≥9) and quality of life (36-item short form) were compared...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28120018/-surgical-treatment-of-achalasia-endoscopic-or-laparoscopic-proposal-for-a%C3%A2-tailored-approach
#20
B H A von Rahden, J Filser, M Al-Nasser, C-T Germer
Primary idiopathic achalasia is the most common form of the rare esophageal motility disorders. A curative therapy which restores the normal motility does not exist; however, the therapeutic principle of cardiomyotomy according to Ernst Heller leads to excellent symptom control in the majority of cases. The established standard approach is Heller myotomy through the laparoscopic route (LHM), combined with Dor anterior fundoplication for reflux prophylaxis/therapy. At least four meta-analyses of randomized controlled trials (RCTs) have demonstrated superiority of LHM over pneumatic dilation (PD); therefore, LHM should be used as first line therapy (without prior PD) in all operable patients...
March 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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