Wei Gong
Southern Medical University, China
Title: Peroral Endoscopic Myotomy For Treating Achalasia Performed By a Gastroenterologist: 4 Years’ Experience From a Single Endoscopy Center
Biography
Biography: Wei Gong
Abstract
Peroral endoscopic myotomy (POEM) has recently been described as a novel treatment for achalasia in humans. We aimed to assess the clinical effectiveness and safety of POEM for treating esophageal achalasia performed by a gastroenterologist in a single endoscopic center within 4 years. Between June 2011 to May 2015, POEM was performed in 115 consecutive patients with achalasia. The Eckardt score and manometry were used to evaluate the outcomes. POEM was successfully performed in all cases. Mean procedure time was 48.7 min (range 35–93) and mean myotomy length was 9.2 cm (range 7–15). Mucosal perforations occurred in 7 (6%) patients during submucosal tunnel creation, major bleeding occurred in 8 (7%) patients, and 6 (5.7%) patients suffered pneumothorax immediate after procedure. All the complications were managed conservatively. During a mean follow-up period of 25 months (range 6–59.4 months), treatment success was achieved in 106/115 patients (93.5%). Mean LES pressure was 54.5 mmHg (28.5–81.4) and 16.4 mmHg (4.8–25.3) before and after the procedure (P < 0.05), respectively. Mean Eckardt score was 6.2 (3–11, median 6) and 0.5 (0–2, median 1) before and after POEM, respectively (P < 0.05). 20 patient (17.3%) developed mild reflux symptoms and required intermittent medication with proton pump inhibitors during the follow-up. Our study demonstrated that POEM is a safe, and effective treatment for achalasia. Further studies are warranted to evaluate the long-term efficacy and to compare POEM with other treatment modalities.