Per-oral Endoscopic Myotomy (POEM): A safe and effective treatment for achalasia in geriatric patients
Keywords:
Esophageal Achalasia, Endoscopy, Esophageal Motility DisordersAbstract
Background: Esophageal achalasia is a primary motor disorder of the esophagus characterized by impair relaxation of the lower esophageal sphincter and absent of esophageal peristalsis. Per-oral endoscopic myotomy is an alternative treatment to surgical Heller myotomy in patients over 65 years old. The aim of this paper was to describe the results of peroral endoscopic myotomy (POEM) or the treatment of achalasia in geriatric patients.
Methods: We included patients over 65 years old with POEM, from retrospective cohort review, in which POEM was performed with a standardized technique in our department.
Results: 12 patients were included, the procedure was successful in 98% of patients, minor adverse events occurred without mortality.
Conclusions: POEM is a safe and effective technique for the treatment of achalasia, the results of the study are similar to those reported in the literature.
Downloads
References
Stavropoulos SN, Modayil R, Friedel D. Achalasia. Gastrointest Endosc Clin N Am. 2013;23(1):53-75.
Pandolfino JE, Gawron AJ. Achalasia. Jama. 2015;313(18):1841.
Boeckxstaens GE, Zaninotto G, Richter JE. Achalasia. Lancet. 2014;383(9911):83-93.
Eckardt V, Aignherr C, Bernhard G. Predictors of outcome in patients with achalasia treated by pneumatic dilation. Gastroenterology. 1992;103(6):1732-8.
Ates F, F Vaezi M. The Pathogenesis and Management of Achalasia: Current Status and Future Directions. Gut Liver. 2015;9(4):449.
Clouse RE, Staiano A. Topography of the esophageal peristaltic pressure Topography of the esophageal peristaltic pressure wave. Am J Physiol Gastrointest Liver Physiol. 1991;261(10):677-84.
Clouse RE, Staiano A, Alrakawi A, Haroian L. Application of topographical methods to clinical esophageal manometry. Am J Gastroenterol. 2000;95(10):2720-30.
Kahrilas PJ, Bredenoord AJ, Fox M, Gyawali CP, Roman S, Smout AJPM, et al. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil. 2015;27(2):160-74.
Tack J, Zaninotto G. Therapeutic options in oesophageal dysphagia. Nat Rev Gastroenterol Hepatol. Nature Publishing Group. 2015;12(6):332-41.
Innoue H, Minami H, Kobayashi Y, Sato Y, Kaga M, Suzuki M, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42(4):265-71.
Hernández-Mondragón OV, González-Martínez M, Blancas-Valencia JM, Altamirano-Castañeda ML, Muñoz-Bautista A. Cartas científicas. Miotomía peroral endoscópica en acalasia. Reporte del primer caso realizado en México. Rev Gastroenterol México. 2015;80(2):165-70.
Chiu PWY, Inoue H, Rösch T. From POEM to POET : Applications and perspectives for submucosal tunnel endoscopy. Endoscopy. 2016;48(12):1134-42.
Werner YB, Rösch T. POEM and Submucosal Tunneling. Curr Treat Options Gastroenterol. 2016;14(2):163-77.
Wang AY. Endoscopic submucosal tunnel dissection: The space between. Gastrointest Endosc. 2013;78(6):953-5.
Hernández Mondragón OV, Rascón Martínez DM, Muñoz Bautista A, Altamirano Castañeda ML, Blanco-Velasco G, Blancas-Valencia JM. The Per Oral Endoscopic Myotomy (POEM) technique: How many preclinical procedures are needed to master it? Endosc Int open. 2015;3(6):E559-65.
Inoue H, Sato H, Ikeda H, Onimaru M, Sato C, Minami H, et al. Per-Oral Endoscopic Myotomy: A Series of 500 Patients. J Am Coll Surg. 2015;221(2):256-64.
Bechara R, Onimaru M, Ikeda H, Inoue H. Per-oral endoscopic myotomy, 1000 cases later: pearls, pitfalls, and practical considerations. Gastrointest Endosc. 2016;84(2):330-8.
Lee BH, Shim KY, Hong SJ, Bok GH, Cho JH, Lee TH, et al. Peroral endoscopic myotomy for treatment of achalasia: Initial results of a Korean study. Clin Endosc. 2013;46(2):161-7.
Grimes KL, Inoue H. Per Oral Endoscopic Myotomy for Achalasia. A Detailed Description of the Technique and Review of the Literature. Thorac Surg Clin. Elsevier Inc. 2016;26(2):147-62.
Familiary P, Gigante G, Marchese M, Boskoski I, Tringali A, Perri V, et al. Peroral Endoscopic Myotomy for Esophageal Achalasia. Ann Surg. 2016;263:82-87.
Csendes A, Braghetto I, Burdiles P, Korn O, Salas J. Tratamiento quirúrgico de la acalasia esofágica. Experiencia en 328 pacientes. Rev Chil Cir. 2012;64(1):46-51.
Csendes A, Braghetto I, Burdiles P, Korn O, Csendes P, Henríquez A. Very late results of esophagomyotomy for patients with achalasia: clinical, endoscopic, histologic, manometric, and acid reflux studies in 67 patients for a mean follow-up of 190 months. Ann Surg. 2006;243(2):196-203.
Bhayani NH, Kurian AA, Dunst CM, Sharata AM, Rieder E SL. A comparative study on comprehensive, objective outcomes of laparoscopic Heller myotomy with per-oral endoscopic myotomy (POEM) for achalasia. Ann Surg. 2014;259(6):1098-103.
Rawlings A, Soper NJ, Oelschlager B, Swanstrom L, Matthews BD, Pellegrini C, et al. Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia: results of a multicenter, prospective, randomized-controlled trial. Surg Endosc. 2012;26(1):18-26.
Vaezi MF, Baker ME, Richter JE. Assessment of esophageal emptying post-pneumatic dilation: use of the timed barium esophagram. Am J Gastroenterol. 1999;94(7):1802-7.
Downloads
Published
Issue
Section
License
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.