title: Peroral endoscopic myotomy for treatment of achalasia: initial results of a korean study.
abstract: OBJECTIVE
  Achalasia is a rare esophageal motility disorder. Recently, a novel endoscopic technique, peroral endoscopic myotomy (POEM), was introduced as an alternative treatment for achalasia. We report the results and short term outcomes of POEM for patients with achalasia.
  
  
  METHODS
  POEM was performed in 13 patients with achalasia. The procedure consisted of creating a submucosal tunnel followed by endoscopic myotomy of circular muscle bundles. The mucosal entry was closed by conventional hemostatic clips. A validated clinical symptom score (Eckardt score) and high resolution manometry were used to evaluate the outcomes.
  
  
  RESULTS
  Both the clinical score of achalasia, as well as the resting lower esophageal sphincter (LES) pressure, were significantly reduced after POEM. Mean posttreatment Eckardt score was 0.4±0.7, compared to 6.4±1.9 prior to the treatment (p=0.001). The mean pretreatment and posttreatment LES pressure was 30.3 and 15.3 mm Hg, respectively (p=0.007). Following POEM, symptomatic relief from dysphagia without reflux symptoms was observed in all patients (13/13). No serious complications related to POEM were encountered.
  
  
  CONCLUSIONS
  Based upon our initial experience, the authors believe that POEM is a feasible, safe, and effective treatment and may possibly substitute established treatments of refractory achalasia.
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Byung Hoo
authors.initials: BH
authors.lastname: Lee
authors.forename: Kwang Yeun
authors.initials: KY
authors.lastname: Shim
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Hong
authors.forename: Gene Hyun
authors.initials: GH
authors.lastname: Bok
authors.forename: Jun-Hyung
authors.initials: JH
authors.lastname: Cho
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Lee
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cho
keywords: Esophageal achalasia; High resolution manometry; Peroral endoscopic myotomy