[Per-oral endoscopic myotomy (POEM) for 43 consecutive cases of esophageal achalasia].

INTRODUCTION

To establish less invasive permanent treatment for esophageal achalasia, per-oral endoscopic myotomy (POEM) was addressed.

PATIENTS: POEM was performed in 43 consecutive cases of achalasia. Among them, nine cases of sigmoidal achalasia were involved. POEM got IRB approval from our hospital. Written informed consent was given to all patients.

PROCEDURE: After creating submucosal tunnel, endoscopic myotomy of circular muscle bundles was carried out at approximately 12cm in total length (10 cm in distal esophagus and 2 cm cardia). Smooth passing of endoscope through GE junction was confirmed at the end of the procedure.

RESULTS

In all cases symptoms of achalasia were dramaticaly reduced or disappeared. Resting pressure was 52.1 mmHg before POEM, and reduced to 18.8 mmHg after procedure. No specific complications related to POEM were experienced. During follow-up period, no additional treatment and no medication were necessary.

CONCLUSION

Short-term outcome of POEM was excellent with no serious complications. Long-term follow up is scheduled.