Peroral Endoscopic Myotomy for Treatment of Achalasia: Initial Results of a Korean Study.
- Author:
Byung Hoo LEE
1
;
Kwang Yeun SHIM
;
Su Jin HONG
;
Gene Hyun BOK
;
Jun Hyung CHO
;
Tae Hee LEE
;
Joo Young CHO
Author Information
- Publication Type:Original Article
- Keywords: Esophageal achalasia; Peroral endoscopic myotomy; High resolution manometry
- MeSH: Deglutition Disorders; Esophageal Achalasia; Esophageal Motility Disorders; Esophageal Sphincter, Lower; Humans; Manometry; Muscles
- From:Clinical Endoscopy 2013;46(2):161-167
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Achalasia is a rare esophageal motility disorder. Recently, a novel endoscopic technique, peroral endoscopic myotomy (POEM), was introduced as an alternative treatment for achalasia. We report the results and short term outcomes of POEM for patients with achalasia. METHODS: POEM was performed in 13 patients with achalasia. The procedure consisted of creating a submucosal tunnel followed by endoscopic myotomy of circular muscle bundles. The mucosal entry was closed by conventional hemostatic clips. A validated clinical symptom score (Eckardt score) and high resolution manometry were used to evaluate the outcomes. RESULTS: Both the clinical score of achalasia, as well as the resting lower esophageal sphincter (LES) pressure, were significantly reduced after POEM. Mean posttreatment Eckardt score was 0.4+/-0.7, compared to 6.4+/-1.9 prior to the treatment (p=0.001). The mean pretreatment and posttreatment LES pressure was 30.3 and 15.3 mm Hg, respectively (p=0.007). Following POEM, symptomatic relief from dysphagia without reflux symptoms was observed in all patients (13/13). No serious complications related to POEM were encountered. CONCLUSIONS: Based upon our initial experience, the authors believe that POEM is a feasible, safe, and effective treatment and may possibly substitute established treatments of refractory achalasia.
