title: Per-oral endoscopic myotomy: emerging indications and evolving techniques.
abstract: Esophageal achalasia is a benign esophageal motility disorder resulting from an impaired relaxation of the lower esophageal sphincter. The principles of treatment involve disruption of the sphincter at the esophagogastric junction. Treatment techniques include balloon dilatation, botulinum toxin injection, and surgical myotomy. In 2008, per-oral endoscopic myotomy (POEM) was introduced by Inoue et al. as an endoscopic myotomy with no skin incision. The procedure has been well accepted and widely applied owing to its minimal invasiveness and high cure rates. Moreover, there have been discussions on wider indications for POEM and new technical developments have been reported. The present article reviews the historical background and present status of POEM, as well as future prospects for its application in the treatment of esophageal achalasia.
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Minami
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue
authors.forename: Amyn
authors.initials: A
authors.lastname: Haji
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Urabe
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hashiguchi
authors.forename: Kayoko
authors.initials: K
authors.lastname: Matsushima
authors.forename: Yuko
authors.initials: Y
authors.lastname: Akazawa
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yamaguchi
authors.forename: Ken
authors.initials: K
authors.lastname: Ohnita
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D004931:Esophageal Achalasia / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D006801:Humans; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods* / Q000639:trends*; D016896:Treatment Outcome
keywords: diffuse esophageal spasm; esophageal achalasia; indocyanine green (ICG); per-oral endoscopic myotomy (POEM); per-oral endoscopic tumor resection