title: Peroral endoscopic myotomy: an evolving treatment for achalasia.
abstract: Peroral endoscopic myotomy (POEM) was first performed in Japan in 2008 for uncomplicated achalasia. With excellent results, it was adopted by highly skilled endoscopists around the world and the indications for POEM were expanded to include advanced sigmoid achalasia, failed surgical myotomy, patients with previous endoscopic treatments and even other spastic oesophageal motility disorders. With increased uptake and performance of POEM, variations in technique and improved management of adverse events have been developed. Now, 6 years since the first case and with >3,000 procedures performed worldwide, long-term data has shown the efficacy of POEM to be long-lasting. A growing body of literature also exists pertaining to the learning curve, application of novel technologies, extended indications and physiologic changes with POEM. Ultimately, this once experimental procedure is evolving towards becoming the preferred treatment for achalasia and other spastic oesophageal motility disorders.
authors.affiliation: Digestive Diseases Centre, Showa University Koto-Toyosu Hospital, Toyosu 5-1-38, Koto-Ku, Tokyo 135-8577, Japan.
authors.forename: Robert
authors.initials: R
authors.lastname: Bechara
authors.affiliation: Digestive Diseases Centre, Showa University Koto-Toyosu Hospital, Toyosu 5-1-38, Koto-Ku, Tokyo 135-8577, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Ikeda
authors.affiliation: Digestive Diseases Centre, Showa University Koto-Toyosu Hospital, Toyosu 5-1-38, Koto-Ku, Tokyo 135-8577, Japan.
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000367:Age Factors; D004931:Esophageal Achalasia / Q000601:surgery*; D015154:Esophageal Motility Disorders / Q000601:surgery; D004945:Esophagoscopy / Q000009:adverse effects / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome