Curriculum for training in peroral endoscopic myotomy (POEM) in Europe (Part I): European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Enrique Rodríguez de Santiago; David J. Tate; João Santos-Antunes; Sandra Nagl; Zuzana Vacková; Marcel Tantau; Isis K. Araujo; Eduardo Guimarães Hourneaux de Moura; Pietro Familiari; Helmut Messmann; Alanna Ebigbo; Paul Fockens; Raf Bisschops; Henriette Heinrich; Eduardo Albéniz; Amrita Sethi; Oleksandr Kiosov; Jan Martinek; Roy Soetikno; Ian M. Gralnek; Tony C. Tham

doi:10.1055/a-2568-7473

Endoscopy, Inhaltsverzeichnis

Endoscopy 2025; 57(07): 778-795
DOI: 10.1055/a-2568-7473

Position Statement

Curriculum for training in peroral endoscopic myotomy (POEM) in Europe (Part I): European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Enrique Rodríguez de Santiago ‡^‡

¹Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Madrid, Spain

²Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain

³Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain

,

David J. Tate‡^‡

⁴Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium

,

João Santos-Antunes

⁵Gastroenterology Department, Centro Hospitalar S. João, Porto, Portugal

,

Sandra Nagl

⁶Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany

,

Zuzana Vacková

⁷Department of Gastrointestinal Endoscopy, Military University Hospital Prague, Prague, Czech Republic

,

Marcel Tantau

⁸University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania

,

Isis K. Araujo

⁹Endoscopy and Motility Unit, Gastroenterology Department, Hospital Clinic de Barcelona, Barcelona, Spain

,

Eduardo Guimarães Hourneaux de Moura

¹⁰Gastrointestinal Endoscopy Unit, Hospital das Clínicas of the University of São Paulo Medical School, São Paulo, Brazil

,

Pietro Familiari

¹¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

,

Helmut Messmann

⁶Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany

,

Alanna Ebigbo

⁶Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany

,

Paul Fockens

¹²Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The Netherlands

¹³Waikato Hospital, Hamilton, New Zealand

,

Raf Bisschops

¹⁴Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium

¹⁵Department of Translational Research in Gastrointestinal Diseases (TARGID), KU Leuven, Leuven, Belgium

,

Henriette Heinrich

¹⁶Clarunis, Universitäres Bauchzentrum, Basel, Switzerland

,

Eduardo Albéniz

¹⁷Gastroenterology Department, Hospital Universitario de Navarra, Navarrabiomed, UPNA, IdiSNA, Pamplona, Spain

,

Amrita Sethi

¹⁸Pancreatobiliary Endoscopy Services, Division of Digestive and Liver Disease, Columbia University Irving Medical Center, New York, New York, USA

,

Oleksandr Kiosov

¹⁹University Clinic, Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine

,

Jan Martinek

²⁰Department of Gastroenterology and Hepatology, St. Anne University Hospital, Brno, Czech Republic

,

Roy Soetikno

²¹Clinical Medicine, University of California San Francisco, California, USA

,

Ian M. Gralnek∗^*

²²Ellen and Pinchas Mamber Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel

²³Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel

,

Tony C. Tham ∗^*

²⁴Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland

› Institutsangaben

Abstract

Main Recommendations

Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure that has become a first-line treatment for esophageal achalasia and other esophageal spastic disorders. Structured training is essential to optimize the outcomes of this technique. The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in POEM. This Position Statement presents the results of a systematic review of the literature and a formal Delphi process, providing recommendations for an optimal training program in POEM that aims to produce endoscopists competent in this procedure. In a separate document (POEM curriculum Part II), we provide technical guidance on how to perform the POEM procedure based on the best available evidence.

1 POEM trainees should acquire a comprehensive theoretical knowledge of achalasia and other esophageal motility disorders that encompasses pathophysiology, diagnostic tool proficiency, clinical outcome assessment, potential adverse events, and periprocedural management.

2 Experience in advanced endoscopic procedures (endoscopic mucosal resection and/or endoscopic submucosal dissection [ESD]) is encouraged as a beneficial prerequisite for POEM training.

3 ESGE suggests that POEM trainees without ESD experience should perform an indicative minimum number of 20 cases on ex vivo or animal models before advancing to human POEM cases with an experienced trainer.

4 ESGE recommends that the trainee should observe an indicative minimum number of 20 live cases at expert centers before starting to perform POEM in humans.

5 The trainee should undertake an indicative minimum number of 10 cases under expert supervision for the initial human POEM procedures, ensuring that trainees can complete all POEM steps independently.

6 ESGE recommends avoiding complex POEM cases during the early training phase.

7 POEM competence should reflect the technical success rate, both the short- and long-term clinical success rates, and the rate of true adverse events.

8 A POEM center should maintain a prospective registry of all procedures performed, including patient work-up and outcomes, procedural techniques, and adverse events.

Volltext

Referenzen

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