title: Peroral Endoscopic Myotomy for Esophageal Achalasia: Outcomes of the First 100 Patients With Short-term Follow-up.
abstract: OBJECTIVE
  Aim of this study is to report the mid-term outcomes of a large series of patients treated with peroral endoscopic myotomy (POEM) in a single European center.
  
  
  BACKGROUND
  POEM is a recently developed treatment of achalasia, which combines the efficacy of surgical myotomy, with the benefits of an endoscopic procedure. Previous studies, including few patients with a short-term follow-up, showed excellent results on dysphagia relief.
  
  
  METHODS
  The first 100 adult patients treated in a single tertiary referral center were retrospectively identified and included in this study (41 men, mean age 48.4 years). Patients were treated according to a standard technique. Follow-up data, including clinical evaluation, and results of esophagogastroduodenoscopy (EGD), manometry, and pH monitoring were collected and analyzed.
  
  
  RESULTS
  POEM was completed in 94% of patients. Mean operative time was 83 minutes (49-140  minutes). No complications occurred. Patients were fed after a median of 2 days (1-4 days). A mean follow-up of 11 months (3-24 months) was available for 92 patients. Clinical success was documented in 94.5% of patients. Twenty-four-hour pH monitoring documented Gastro-Esophageal Reflux Disease (GERD) in 53.4% of patients. However, only a minority of patients had heartburn (24.3%) or esophagitis (27.4%), and these patients were successfully treated with proton-pump inhibitors.
  
  
  CONCLUSIONS
  Our results confirm the efficacy of POEM in a large series of patients, with a mean follow-up of 11 months. Should our results be confirmed by long-term follow-up studies, POEM may become one of the first-line therapies of achalasia in the next future.
authors.affiliation: Digestive Endoscopy Unit-Gemelli University Hospital, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Familiari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gigante
authors.forename: Michele
authors.initials: M
authors.lastname: Marchese
authors.forename: Ivo
authors.initials: I
authors.lastname: Boskoski
authors.forename: Andrea
authors.initials: A
authors.lastname: Tringali
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Perri
authors.forename: Guido
authors.initials: G
authors.lastname: Costamagna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004931:Esophageal Achalasia / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult