title: Per-oral endoscopic myotomy (POEM) for esophageal achalasia.
abstract: Per-oral endoscopic myotomy (POEM) is a new minimally invasive endoscopic treatment for achalasia. Since the first modern human cases were published in 2008, around 2,000 cases have been performed worldwide. This technique requires advanced endoscopic skills and a learning curve of at least 20 cases. POEM is highly successful with over 90 % improvement in dysphagia while offering patients the advantage of a low impact endoscopic access. The main long-term complication is gastroesophageal reflux (GER) with an estimated incidence of 35 %, similar to the incidence of GER post-laparoscopic Heller with fundoplication. Although POEM represents a paradigm shift in the treatment of achalasia, more long-term data are clearly needed to further define its role in the treatment algorithm of this rare disease.
authors.affiliation: Providence Cancer Center, Division of Gastrointestinal and Minimally Invasive Surgery, The Oregon Clinic, Portland, OR, USA.
authors.forename: Radu
authors.initials: R
authors.lastname: Pescarus
authors.forename: Eran
authors.initials: E
authors.lastname: Shlomovitz
authors.forename: Lee L
authors.initials: LL
authors.lastname: Swanstrom
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003680:Deglutition Disorders / Q000209:etiology; D004502:Education, Medical, Continuing / Q000379:methods; D004931:Esophageal Achalasia / Q000150:complications / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D004945:Esophagoscopy / Q000009:adverse effects / Q000193:education / Q000379:methods* / Q000592:standards; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000193:education / Q000379:methods / Q000592:standards; D018579:Patient Selection; D011182:Postoperative Care / Q000379:methods; D055815:Young Adult