Document Detail

Peroral endoscopic myotomy for the treatment of achalasia: a prospective single center study.
MedLine Citation:
PMID:  22068665     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Endoscopic balloon dilatation and laparoscopic myotomy are established treatments for achalasia. Recently, a new endoscopic technique for complete myotomy was described. Herein, we report the results of the first prospective trial of peroral endoscopic myotomy (POEM) in Europe.
METHODS: POEM was performed under general anesthesia in 16 patients (male:female (12:4), mean age 45 years, range 26-76). The primary outcome was symptom relief at 3 months, defined as an Eckhard score ≤3. Secondary outcomes were procedure-related adverse events, lower esophageal sphincter (LES) pressure on manometry, reflux symptoms, and medication use before and after POEM.
RESULTS: A 3-month follow-up was completed for all patients. Treatment success (Eckhard score ≤3) was achieved in 94% of cases (mean score pre- vs. post-treatment (8.8 vs. 1.4); P<0.001). Mean LES pressure was 27.2 mm Hg pre-treatment and 11.8 mm Hg post-treatment (P<0.001). No patient developed symptoms of gastro-esophageal reflux after treatment, but one patient was found to have an erosive lesion (LA grade A) on follow-up esophagogastroduodenoscopy. No patient required medication with proton pump inhibitors or antacids after POEM.
CONCLUSIONS: POEM is a promising new treatment for achalasia resulting in short-term symptom relief in >90% of cases. Studies evaluating long-term efficacy and comparing POEM with established treatments have been initiated.
Daniel von Renteln; Haruhiro Inoue; Hiromi Minami; Yuki Birgit Werner; Andrea Pace; Jan Felix Kersten; Chressen Catharina Much; Guido Schachschal; Oliver Mann; Jutta Keller; Karl-Hermann Fuchs; Thomas Rösch
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-11-08
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  107     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-05     Completed Date:  2012-04-27     Revised Date:  2012-12-03    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  411-7     Citation Subset:  IM    
Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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MeSH Terms
Esophageal Achalasia / diagnosis,  surgery*
Esophagus / surgery
Length of Stay / statistics & numerical data
Middle Aged
Natural Orifice Endoscopic Surgery / methods*
Prospective Studies
Treatment Outcome
Comment In:
Endoscopy. 2012 Apr;44(4):399-402   [PMID:  22438150 ]
Am J Gastroenterol. 2012 Oct;107(10):1586; author reply 1586   [PMID:  23034613 ]

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