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POEM in the Treatment of Esophageal Disorders

  • Nasim Parsa
  • Mouen A. KhashabEmail author
Esophagus (PG Iyer, Section Editor)
  • 250 Downloads
Part of the following topical collections:
  1. Topical Collection on Esophagus

Opinion statement

Purpose of the review

Peroral endoscopic myotomy (POEM) is a novel minimally invasive technique that has emerged as the preferred option for the treatment of achalasia and spastic esophageal disorders (SED) at many centers around the world. In this article, we review and summarize the recent literature on POEM in patients with achalasia and SED. The current article is largely focused on the new developments and findings, extended applications, and long-term outcomes of POEM in patients with achalasia and SED.

Recent findings

POEM is a safe and effective therapy for patients with achalasia and SED. POEM is comparable to Heller myotomy (HM) in terms of safety, efficacy, and complications, including gastroesophageal reflux disease (GERD). Outcomes of POEM are excellent even in patients who had prior failed therapies for achalasia, including failed HM and prior POEM. Recent data also suggest the efficacy and safety of POEM in both pediatric and geriatric patients. GERD after POEM is common, and the majority of patients are asymptomatic. The management, goals of therapy, and long-term outcomes of GERD after POEM are unclear. Objective testing for all patients is recommended.

Summary

POEM is a validated treatment for all patients with achalasia and SED. Candidates should be carefully selected and appropriately counseled on expected outcomes and the need for long-term surveillance.

Keywords

POEM Peroral endoscopic myotomy Achalasia Esophageal motility disorders Heller myotomy Outcomes 

Notes

Compliance with Ethical Standards

Conflict of Interest

Nasim Parsa declares no conflict of interest.

Mouen A. Khashab is a consultant for Boston Scientific and Olympus America. He also serves on the medical advisory board of Boston Scientific and Olympus America.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance ••Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyJohns Hopkins HospitalBaltimoreUSA
  2. 2.Department of Internal MedicineMedStar Harbor HospitalBaltimoreUSA

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