Peroral endoscopic myotomy compared with pneumatic dilation for newly diagnosed achalasia

  title={Peroral endoscopic myotomy compared with pneumatic dilation for newly diagnosed achalasia},
  author={Fandong Meng and Peng Li and Yong-jun Wang and Ming Ji and Yong-dong Wu and Li Yu and Ying-lin Niu and Fu-jing Lv and Wei Li and Wen-yan Li and Huihong Zhai and Shanshan Wu and Shutian Zhang},
  journal={Surgical Endoscopy},
BackgroundThis study retrospectively compared the safety and efficacy of two endoscopic techniques for treating newly diagnosed achalasia, pneumatic dilation (PD), and peroral endoscopic myotomy (POEM).MethodsDemographics, 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.ResultsOf 72 patients, 32 and 40 received POEM and PD, respectively… 

Peroral endoscopic myotomy versus pneumatic dilation for achalasia: a systematic review and meta-analysis

The current evidence suggests that the long-term efficacy of POEM was superior to that of pneumatic dilation, but accompanied by higher complications.

Outcome of peroral endoscopic myotomy (POEM) in treatment-naive patients. A systematic review

A more systematic and standardized evaluation is recommended to improve the reports on outcome of POEM and the follow-up rate should be high and the evaluation protocol should include both symptom scoring and objective testing with predefined treatment goals.

Peroral endoscopic myotomy (POEM) vs pneumatic dilation (PD) in treatment of achalasia: A meta-analysis of studies with ≥ 12-month follow-up

POEM is more efficacious than PD in the treatment of patients with achalasia during short-term and long-term follow-up, albeit with higher risk of abnormal esophageal acid exposure.

Clinical outcomes of peroral endoscopic myotomy for achalasia in children: a systematic review and meta-analysis.

It is demonstrated that the POEM was an effective and safe technique for treating achalasia in children and further randomized comparative studies of POEM and other therapeutic methods are warranted to determine the most effective treatment modality for achalAsia in children.

Is peroral endoscopic myotomy (POEM) more effective than pneumatic dilation and Heller myotomy? A systematic review and meta-analysis

POEM has similar outcomes to HM and greater efficacy than PD, including treatment-related serious adverse events, and similar safety outcomes to both HM and PD.

Endoscopic Myotomy for Foregut Motility Disorders.

Gastroesophageal reflux is not infrequent after POEM but does not seem significantly different from reflux that occurs after Heller myotomy, and POEM also seems to be effective in the treatment of spastic esophagal disorders.

Difficult peroral endoscopic myotomy: definition and management strategies

A comprehensive review of difficult POEM is provided, focusing on its definition, risk factors, and intraoperative management strategies, and is expected to provide tips for not so experienced operators who perform POEM.

Outcome of Pneumatic Balloon Dilatation in Achalasia Cardia

PD is safe and effective treatment modality for Achalasia, while younger patients have poor response to treatment with Pneumatic Dilatation, while predilatation Lower Esophageal Sphincter pressure, gender and type of achalasia did not affect the treatment outcome.

Anterior versus posterior approach in peroral endoscopic myotomy (POEM): a systematic review and meta-analysis.

Anterior and posterior myotomy in POEM seem comparable to each other in terms of clinical success, gastroesophageal reflux disease (GERD), and adverse events.

Peroral Endoscopic Myotomy for Esophageal Motility Disorders

Currently, POEM is a representative procedure of natural orifice transluminal endoscopic surgery, which has shown a good clinical efficacy with low complication rates for esophageal motility disorders including achalasia, however, further studies are needed to treat non-achalasia motility disorder via POEM.



Pneumatic dilation versus laparoscopic Heller's myotomy for idiopathic achalasia.

After 2 years of follow-up, laparoscopic Heller's myotomy, as compared with pneumatic dilation, was not associated with superior rates of therapeutic success.

Peroral endoscopic myotomy (POEM) for esophageal achalasia.

The short-term outcome ofPOEM for achalasia was excellent; further studies on long-term efficacy and on comparison of POEM with other interventional therapies are awaited.

Treatment of Achalasia with Laparoscopic Myotomy or Pneumatic Dilatation: Long-Term Results of a Prospective, Randomized Study

This long-term follow-up of a randomized clinical study shows that LM is superior to repetitive PD treatment of newly diagnosed achalasia, albeit that this surgical strategy is burdened by high initial direct medical costs.

Surgery or Peroral Esophageal Myotomy for Achalasia

POEM represents a safe and efficacy procedure comparable to the safety profile of LHM for achalasia at a short-term follow-up, and long-term clinical trials are urgently needed.

Per-Oral Endoscopic Myotomy: A Series of 500 Patients.

Peroral endoscopic myotomy: an evolving treatment for achalasia

Long-term data has shown the efficacy of POEM to be long-lasting and this once experimental procedure is evolving towards becoming the preferred treatment for achalasia and other spastic oesophageal motility disorders.

Outcomes of treatment for achalasia depend on manometric subtype.

A higher percentage of patients with type II achalasia (based on manometric tracings) are treated successfully with pneumatic dilation or laparoscopic Heller myotomy than patients with types I and III a Chalasia.

A Matched Comparison of Per Oral Endoscopic Myotomy to Laparoscopic Heller Myotomy in the Treatment of Achalasia

Early clinical outcomes are excellent with POEM and comparable to the standard of care LHM, and long-term follow-up is required as concerns for reflux persist.

Major perioperative adverse events of peroral endoscopic myotomy: a systematic 5-year analysis.

In general, POEM appears to be a safe procedure, and major adverse events were rare and could usually be prevented or anticipated, and were all managed effectively.

Endoscopic Therapy for Achalasia Before Heller Myotomy Results in Worse Outcomes Than Heller Myotomy Alone

Endoscopic therapy for achalasia should not be used unless patients are not candidates for surgery, and use of preoperative endoscopic therapy remains common and has resulted in more intraoperative complications, primarily perforation, more post operative complications, and a higher rate of failure than when no preoperative therapy was used.