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Per oral endoscopy myotomy

Yuki B Werner, Daniel von Renteln, Tania Noder, Guido Schachschal, Ulrike W Denzer, Stefan Groth, Jan F Nast, Jan F Kersten, Martin Petzoldt, Gerhard Adam, Oliver Mann, Alessandro Repici, Cesare Hassan, Thomas Rösch
BACKGROUND & AIMS: The recently developed technique of per-oral endoscopic myotomy (POEM) has been shown to be effective for the therapy of esophageal motility disorders. Limited information is available about POEM adverse events (AE). METHODS: POEM was performed with the patients under general anesthesia in 241 patients (58% male, mean age 47.4 ± 16.4 years) during 61 months. Main outcome was the rate of intra- and post-procedural adverse events (AE). Post-procedural checks comprised clinical and laboratory examination, and endoscopy, with further follow-ups being performed at 3, 6 and 12 months, respectively...
September 5, 2016: Gastrointestinal Endoscopy
Stavros N Stavropoulos, Rani Modayil, David Friedel
Per-oral endoscopic myotomy has emerged as the preferred option for treatment of achalasia. This entirely endoscopic procedure has clinical efficacy and lower esophageal sphincter disruption comparable to laparoscopic Heller myotomy with lesser postprocedure pain and length of stay. This review describes per-oral endoscopic myotomy technique, evolution, patient selection, comparison to other therapies, training, and future considerations, including extrapolation of tunnel endoscopy to other situations.
2016: Seminars in Thoracic and Cardiovascular Surgery
Haruhiro Inoue
As a minimally invasive treatment of esophageal achalasia per-oral endoscopic myotomy( POEM) was developed in 2008. More than 1,100 cases of achalasia-related diseases received POEM. Success rate of the procedure was more than 95%(Eckerdt score improvement 3 points and more). No serious( Clavian-Dindo classification III b and more) complication was experienced. These results suggest that POEM becomes a standard minimally invasive treatment for achalasia-related diseases. As an off-shoot of POEM submucosal tumor removal through submucosal tunnel (per-oral endoscopic tumor resection:POET) was developed and safely performed...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Dario Esposito, Francesco Maione, Alessandra D'Alessandro, Giovanni Sarnelli, Giovanni D De Palma
Achalasia is a motility disorder of the esophagus characterized by dysphagia, regurgitation of undigested food, chest pain, weight loss and respiratory symptoms. The most common form of achalasia is the idiopathic one. Diagnosis largely relies upon endoscopy, barium swallow study, and high resolution esophageal manometry (HRM). Barium swallow and manometry after treatment are also good predictors of success of treatment as it is the residue symptomatology. Short term improvement in the symptomatology of achalasia can be achieved with medical therapy with calcium channel blockers or endoscopic botulin toxin injection...
January 25, 2016: World Journal of Gastrointestinal Endoscopy
Dennis Hong, Radu Pescarus, Rana Khan, Luciano Ambrosini, Mehran Anvari, Margherita Cadeddu
BACKGROUND: Per oral endoscopic myotomy (POEM) is a viable alternative to standard Heller myotomy for surgical treatment of achalasia. Outcomes from the United States, Europe and Asia have been reported. We sought to report data after the initiation of POEM in a Canadian centre. METHODS: We enrolled patients with achalasia in a research ethics board-approved pilot study. Surgeons learned the POEM procedure in a systematic manner that included visiting experts in POEM, practice in an animal laboratory and mentoring from POEM experts...
December 2015: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Fatih Aslan, Zehra Akpınar, Emrah Alper, Aynur Atay, Derya Aslan Yurtlu, Cem Çekiç, Serhat Bor, Belkis Ünsal
BACKGROUND/AIMS: Per-oral endoscopic myotomy (POEM) is a minimally invasive endoscopic treatment option for patients with achalasia and has been performed since 2010. It is less invasive than Heller myotomy and its use is spreading rapidly worldwide. We present our results of POEM that, to the best of our knowledge, are the first cases in Turkey. MATERIALS AND METHODS: We enrolled patients between May 2014 and September 2014; 8 patients with achalasia whose complaints recurred after pneumatic balloon dilatation underwent POEM...
May 2015: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Robert Bechara, Haruhiro Inoue
Over the past 30 years, the field of endoscopy has witnessed several advances. With the advent of endoscopic mucosal resection, removal of large mucosal lesions have become possible. Thereafter, endoscopic submucosal resection was refined, permitting en bloc removal of large superficial neoplasms. Such techniques have facilitated the development of antireflux mucosectomy, a promising novel treatment for gastroesophageal reflux. The introduction and use of over the scope clips has allowed for endoscopic closure of defects in the gastrointestinal tract, which were traditionally treated with surgical intervention...
May 16, 2015: World Journal of Gastrointestinal Endoscopy
Eran Shlomovitz, Radu Pescarus, Maria A Cassera, Ahmed M Sharata, Kevin M Reavis, Christy M Dunst, Lee L Swanström
INTRODUCTION: Gastroparesis is a condition characterized by delayed gastric emptying, and a constellation of symptoms, including nausea, vomiting, early satiety, and bloating. Although current surgical options such as pyloroplasty have been shown to be effective, an endoscopic submucosal myotomy technique may be applied to divide the pyloric sphincter without surgical access. Such endoscopic technique may provide the benefits of a natural orifice procedure, and improve gastric emptying in gastroparetic patients...
March 2015: Surgical Endoscopy
Ahmed Sharata, Ashwin A Kurian, Christy M Dunst, Neil H Bhayani, Kevin M Reavis, Lee L Swanstrom
BACKGROUND: Per-Oral Endoscopic Myotomy (POEM) is becoming an acceptable alternative to laparoscopic cardiomyotomy for esophageal motility disorders. The aim of this video is to provide key technical steps to completing this procedure. METHOD: Each patient underwent diagnostic investigations including high resolution manometry (HRM), esophageogastroduodenoscopy (EGD), and timed-barium swallow for primary esophageal motility disorders preoperatively. Patients undergoing POEM procedures are preoperatively prepared by taking Nystatin swish-and-swallow for 3 days, 24 h of clear liquid diet, and 12 h of NPO...
April 2014: Surgical Endoscopy
A J Bredenoord, T Rösch, P Fockens
BACKGROUND: Treatment of achalasia is complicated by symptom recurrence and a significant risk for severe complications. Endoscopic myotomy was developed in the search for a highly efficacious treatment with lower risks. Since its introduction in 2010, several centers have adopted the technique and published excellent short-term results of open label series. Randomized trials with long-term endpoint comparing per-oral endoscopic myotomy (POEM) with the established treatments such as balloon dilation and surgical myotomy are now warranted, before POEM can be regarded as the routine clinical care for achalasia patients...
January 2014: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Hitomi Minami, Naoyuki Yamaguchi, Kayoko Matsushima, Yuko Akazawa, Ken Ohnita, Fuminao Takeshima, Toshiyuki Nakayama, Tomayoshi Hayashi, Haruhiro Inoue, Kazuhiko Nakao, Hajime Isomoto
BACKGROUND: Per oral endoscopic myotomy (POEM) has been reported to be a new therapeutic option for esophageal achalasia. The possibility that POEM could reduce the risk of developing esophageal squamous cell carcinoma was evaluated. METHODS: This was a single-centre, retrospective study. Fifteen consecutive patients with esophageal achalasia who underwent POEM in our institution between August 2010 and January 2012 were enrolled. Ultra-high magnification with endocytoscopy was performed, and both histopathological and immunohistochemical evaluations for Ki-67 and p53 were assessed before and 3 months after POEM...
2013: BMC Gastroenterology
Lee L Swanstrom, Ashwin Kurian, Christy M Dunst, Ahmed Sharata, Neil Bhayani, Erwin Rieder
BACKGROUND: Esophageal achalasia is most commonly treated with laparoscopic myotomy or endoscopic dilation. Per-oral endoscopic myotomy (POEM), an incisionless selective myotomy, has been described as a less invasive surgical treatment. This study presents 6-month physiological and symptomatic outcomes after POEM for achalasia. METHODS: Data on single-institution POEMs were collected prospectively. Pre- and postoperative symptoms were quantified with Eckardt scores...
October 2012: Annals of Surgery
Xavier Dray, Anthony N Kalloo
No abstract text is available yet for this article.
October 2012: Digestive and Liver Disease
Konstantinos I Makris, Erwin Rieder, Lee L Swanstrom
Natural orifice transluminal endoscopic surgery (NOTES) proposes the possibility of less-invasive, incisionless surgery. Initially conceived to replace abdominal procedures, more recently interest has focused on mediastinal and thoracic procedures as possible logical applications of transluminal approaches. A survey of the literature as well as the author's own experience is performed, examining experimental and increasingly human use of mediastinal and thoracoscopic flexible endoscopy. Issues regarding instrumentation, orientation, and best access are discussed...
2010: Seminars in Thoracic and Cardiovascular Surgery
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