Peroral Endoscopic Myotomy for Achalasia
Michael Ujiki, Vanessa N. VanDruff
Abstract
BACKGROUND: Peroral endoscopic myotomy (POEM) utilizes the principles of natural orifice transluminal surgery to create an operative tunnel within the submucosal space, perform an endoluminal esophagogastromyotomy, and ultimately mitigate the progressive symptoms of achalasia. POEM is an innovative minimally invasive technique increasing in popularity and clinical significance as an effective treatment for achalasia and other disorders of spastic esophageal motility. METHODS: A comprehensive literature review was performed regarding the procedure, outcomes, and technical advancements in POEM. RESULTS: A growing number of studies world-wide have shown that POEM is a safe and effective for all types of achalasia, sigmoid and non-sigmoid type. CONCLUSIONS: POEM continues to gain traction as a highly effective therapeutic modality for achalasia. As natural orifice transluminal surgery advances, further research is necessary to optimize utilization of endoluminal functional imaging, to tailor endoscopic technique, and to address the adverse effect of post-operative reflux and esophagitis.