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1. Peroral Endoscopic Myotomy (POEM) > Fact Sheets – Yale Medicine
There are several treatments for achalasia, but POEM, a recently developed procedure, is increasingly being used. POEM relieves symptoms in around 90% of achalasia cases, and serious complications are rare. “POEM is an exciting technique used to perform a myotomy of the LES for the treatment of achalasia,” says Yale Medicine.
2. per-oral Endoscopic Myotomy (POEM) for Treatment of Achalasia
Per-oral Endoscopic Myotomy (POEM) for Treatment of Achalasia. New approaches to treating achalasia, a neuromuscular condition marked by difficulty swallowing, successfully reduce esophageal sphincter pressure, while avoiding the need for laparoscopic surgery.The standard surgical option for achalasia is Heller myotomy, a laparoscopic…
3. POEM | Achalasia Treatment | What to Expect | IU Health
patients with achalasia have a tight muscle called the lower esophageal sphincter.The muscle tightness makes it hard for liquids,foods and medications to pass through normally. … You will discuss options for treatment.POEM is an excellent treatment option for some patients,but not…red on a case-by-case basis after other less invasive approaches have been exhausted, the update states.
For perspective on the POEM clinical practice update, Medscape Medical News spoke with Mouen Khashab, MD, director of Therapeutic Endoscopy, Johns Hopkins University, Baltimore, and member of the American Society for Gastrointestinal Endoscopy.
“The document is very well written and comprehensive, and in terms of the best practices, I’m pretty much in agreement with all of them,” Khashab said.
Though, Khashab said he would have liked to see greater emphasis on the value or role of a short myotomy in the esophagus and cardia.
“There is level I evidence that the short esophageal myotomy is equivalent to a long esophageal myotomy for type I and II achalasia. When you do a short myotomy, you save procedure time and there is potentially a lower incidence of blown-out myotomy or BOM,” Khashab told Medscape medical News.Khashab also noted that a long myotomy on the gastric side “likely increases the risk of reflux disease, and therefore a limited myotomy on the gastric side likely also is beneficial.”
This research had no commercial funding. Yang serves as a consultant for Boston Scientific, Olympus, FujiFilm, Microtech, Medtronic, 3D-Matrix, and Neptune Medical; and received research support from Microtech and 3D-Matrix. Khashab had no relevant disclosures.
Q: What is the significance of POEM in the treatment of achalasia?
Table of Contents
- Q: What is the significance of POEM in the treatment of achalasia?
- Q: How does POEM compare to customary surgical treatments like Heller myotomy?
- Q: What are the primary advantages of choosing POEM for treating achalasia?
- Q: How does the incidence of complications differ between POEM and traditional surgeries for achalasia?
- Q: Can you elaborate on the long-term effects of POEM in comparison to traditional surgical treatments?
- Q: When would you recommend POEM over traditional surgical interventions for achalasia patients?
POEM is a cutting-edge technique that facilitates the myotomy of the lower esophageal sphincter (LES) to ameliorate achalasia, a condition characterized by difficulty swallowing. This minimally invasive approach highlights an essential breakthrough in addressing the disorder as of its effectiveness in treating the primary cause—the hypertonic LES.
Q: How does POEM compare to customary surgical treatments like Heller myotomy?
POEM offers a less invasive alternative to traditional methods like Heller myotomy, which necessitates laparoscopic surgery. While Heller myotomy has been the standard, POEM stands out for its ability to achieve significant reductions in LES pressure without the associated risks and recovery times of laparoscopic surgery.
Q: What are the primary advantages of choosing POEM for treating achalasia?
The primary advantages of POEM include its minimally invasive nature, which often leads to quicker recovery times and reduced postoperative discomfort. Additionally, POEM is associated with a potentially lower risk of recurrent Coulston reflux disease compared to traditional surgical methods.
Q: How does the incidence of complications differ between POEM and traditional surgeries for achalasia?
According to the insights shared by Mouen Khashab, MD, POEM may potentially reduce the occurrence of blown-out myotomy (BOM). This benefit contributes to the emergence of POEM as a more refined and precise treatment modality. However, it is vital to note that the choice between POEM and traditional surgery is often based on the individual patient’s clinical needs and response to prior treatments.
Q: Can you elaborate on the long-term effects of POEM in comparison to traditional surgical treatments?
Dr. Khashab highlights that a limited myotomy on the gastric side during POEM likely reduces the risk of reflux disease in the long term. This nuanced approach reflects a strategic advantage,as it preserves the functional integrity of the gastric region while effectively treating the underlying condition.
Q: When would you recommend POEM over traditional surgical interventions for achalasia patients?
POEM is often recommended for patients who have not responded satisfactorily to less invasive treatments or those seeking a minimally invasive option with potentially reduced postoperative complications. Given its customized approach and detailed evaluation on a case-by-case basis, POEM presents as a pragmatic solution within the spectrum of therapeutic choices for achalasia patients.