Peroral endoscopic myotomy in the treatment of achalasia

VernacularTitle:内镜下食管肌层切开术治疗贲门失弛缓症
Author: Lei WANG ; Xiaoyan ZHAO ; Xia ZHANG ; Lu LIU ; Guoce ZHAO
Publication Type:Journal Article
Keywords: Achalasia; Esophageal myotomy; Endoscopy
From: Chinese Journal of Digestive Surgery 2010;09(6):472-473
CountryChina
Language:Chinese
Abstract: Achalasia is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter. It is characterized by difficulty swallowing, regurgitation, and sometimes chest pain. Peroral endoscopic myotomy (POEM) was developed by Inoue to provide a less invasive permanent treatment for esophageal achalasia. We applied this method to cure successfully a 47-year-old female with achalasia. The procedure was as follows: after creating submucosal tunnel, endoscopic myotomy of circular muscle bundles was carried out at approximately 16 cm in total length ( 15 cm in distal esophagus and 1 cm in cardia). Smooth passing of endoscope through gastroesophageal junction was confirmed at the end of the procedure. The third day after POEM, the barium meal examination revealed the barium smoothly passed though the cardia. The short-term outcome of POEM for achalasia was excellent, and further studies on long-term efficacy and on comparison of POEM with other interventional therapies are awaited.