Digestive Disease Interventions 2021; 05(01): 017-021
DOI: 10.1055/s-0041-1726813
Review Article

Long-Term Outcomes of POEM for Primary Esophageal Motility Disorders

1  Department of Surgery, Westchester Medical Center, Valhalla, New York
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2  Department of Surgery, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
› Author Affiliations

Abstract

Since peroral endoscopic myotomy (POEM) emerged in 2010 as a treatment for achalasia, more than 7,000 procedures have been performed in the world. The main indication for POEM continues to be achalasia, which is a rare esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and aperistalsis. POEM has also been applied in other types of primary esophageal motility disorders. Short-term outcomes indicate that POEM has comparable results to laparoscopic Heller myotomy in terms of efficacy and safety. Studies show decrease in Eckardt scores after POEM as a reflection of symptomatic relief. Now, a decade after its introduction, long-term data have emerged for POEM and demonstrates that POEM remains effective and safe. Both POEM and laparoscopic Heller myotomy are associated with postinterventional gastroesophageal reflux disease (GERD). Antireflux mechanisms are disrupted during the procedures. However, the rate of GERD is higher after POEM than with laparoscopic Heller myotomy. Laparoscopic Heller myotomy is commonly performed with a partial fundoplication to reduce antireflux, but POEM is not typically combined with an antireflux procedure. Further studies should examine the long-term effects of postinterventional GERD.



Publication History

Received: 10 October 2020

Accepted: 15 January 2021

Publication Date:
18 March 2021 (online)

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