Peroral Endoscopic Myotomy: Establishing a New Program

Nikhil A. Kumta, Shivani Mehta, Prashant Kedia, Kristen Weaver, Reem Z. Sharaiha, Norio Fukami, Hitomi Minami, Fernando Casas, Monica Gaidhane, Arnon Lambroza, Michel Kahaleh

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Achalasia is an esophageal motility disorder characterized by incomplete relaxation of the lower esophageal sphincter (LES) and aperistalsis of the esophageal body. Treatment of achalasia is aimed at decreasing the resting pressure in the LES. Peroral endoscopic myotomy (POEM), derived from natural orifice transluminal endoscopic surgery (NOTES) and advances in endoscopic submucosal dissection (ESD), presents a novel, minimally invasive, and curative endoscopic treatment for achalasia. POEM involves an esophageal mucosal incision followed by creation of a submucosal tunnel crossing the esophagogastric junction and myotomy before closure of the mucosal incision. Although the procedure is technically demanding and requires a certain degree of skill and competency, treatment success is high (90%) with low complication rates. Since the first described POEM in humans in 2010, it has been used increasingly at centers worldwide. This article reviews available published clinical studies demonstrating POEM efficacy and safety in order to present a proposal on how to establish a dedicated POEM program and reach base proficiency for the procedure.

Original languageEnglish (US)
Pages (from-to)389-397
Number of pages9
JournalClinical Endoscopy
Volume47
Issue number5
DOIs
StatePublished - Jan 1 2014

Keywords

  • Achalasia
  • Myotomy
  • Natural orifice endoscopic surgery
  • Peroral endoscopic myotomy
  • Therapeutics

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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    Kumta, N. A., Mehta, S., Kedia, P., Weaver, K., Sharaiha, R. Z., Fukami, N., Minami, H., Casas, F., Gaidhane, M., Lambroza, A., & Kahaleh, M. (2014). Peroral Endoscopic Myotomy: Establishing a New Program. Clinical Endoscopy, 47(5), 389-397. https://doi.org/10.5946/ce.2014.47.5.389