Endoscopic Myotomy for Foregut Motility Disorders

Mouen Khashab, Petros C. Benias, Lee L. Swanstrom

Research output: Contribution to journalArticle

Abstract

Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure classically performed for the treatment of achalasia. The procedure is based on principles of submucosal endoscopy and is composed of a mucosal incision, submucosal tunneling, myotomy, and mucosal closure. Multiple published studies that collectively include more than 6000 patients reported clinical success in more than 80% to 90% of patients. Recent literature also suggested durability of response over a medium-term follow-up. POEM is associated with a low rate of adverse events when performed by experienced operators. Gastroesophageal reflux is not infrequent after POEM but does not seem significantly different from reflux that occurs after Heller myotomy. POEM also seems to be effective in the treatment of spastic esophageal disorders (eg, jackhammer and diffuse esophageal spasm). Last, the role of gastric POEM (G-POEM) in the treatment of gastroparesis has been investigated in recent studies with promising results.

Original languageEnglish (US)
Pages (from-to)1901-1910
Number of pages10
JournalGastroenterology
Volume154
Issue number7
DOIs
StatePublished - May 1 2018

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Keywords

  • Dysphagia
  • Gastroparesis
  • Heller Myotomy
  • Myotomy
  • POEM
  • Reflux

ASJC Scopus subject areas

  • Gastroenterology

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