Peroral endoscopic myotomy for esophageal motility disorders

Esophagus. 2020 Jan;17(1):11-18. doi: 10.1007/s10388-019-00693-w. Epub 2019 Oct 12.

Abstract

Background: Esophageal motility disorders which include achalasia, esophagogastric junction outflow obstruction (EGJ outflow obstruction), jackhammer esophagus (JE), distal esophageal spasm (DES), etc. are rare disease of unknown causes. The diagnosis is based on endoscopy, barium meal, and high-resolution manometry (HRM). With the development of endoscopy, peroral endoscopic myotomy (POEM) has emerged as a standard method for the treatment of achalasia.

Purpose: The purpose of this article is to enable gastroenterologists to have a more comprehensive understanding of the application status, technical characteristics, clinical efficacy and future prospect of POEM in the treatment of esophageal motility disorders.

Methods: Through a large number of reading literature, combined with clinical practice, summary and analysis of the indications, procedure, efficacy, complications, and controversies of POEM in the treatment of esophageal motility disorders, as well as the current and future perspectives of POEM were studied.

Results: POEM is safe and effective in the treatment of esophageal motility disorders, but the GERD reflux rate is higher.

Conclusions: POEM can be a new option for the treatment of esophageal movement disorders, but large sample, multi-center, long-term study reports are needed, and it promotes the development of NOTES technology.

Keywords: Achalasia; Esophageal motility disorders; Peroral endoscopic myotomy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Digestive System Surgical Procedures / adverse effects
  • Esophageal Achalasia / etiology
  • Esophageal Achalasia / surgery*
  • Esophageal Motility Disorders / complications
  • Esophageal Motility Disorders / surgery*
  • Esophageal Spasm, Diffuse / etiology
  • Esophageal Sphincter, Lower / physiopathology
  • Esophagogastric Junction / physiopathology
  • Gastric Outlet Obstruction / etiology
  • Gastroenterologists / education
  • Gastroesophageal Reflux / epidemiology
  • Humans
  • Myotomy / adverse effects
  • Myotomy / methods*
  • Natural Orifice Endoscopic Surgery / methods*
  • Natural Orifice Endoscopic Surgery / standards
  • Postoperative Complications / epidemiology
  • Safety
  • Treatment Outcome