Short-term outcomes of POEM

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  • Higuchi Kazutoshi
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Goto Osamu
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Hoshino Shintaro
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Kawami Noriyuki
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Koizumi Eriko
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Kirita Kumiko
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Noda Hiroto
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Onda Takeshi
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Akimoto Teppei
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Omori Jun
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Kaise Mitsuru
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
  • Iwakiri Katsuhiko
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine

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  • 当院におけるPOEMの短期治療成績の検討

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<p> (Background and Aim) We investigated the short-term outcomes of per-oral endoscopic myotomy (POEM) in patients with an esophageal functional disorder at our institution.</p><p> (Method) We retrospectively evaluated 16 cases of POEM, which were performed from October 2018 to December 2019. Surgical outcomes and efficacy were assessed.</p><p> (Results) There were 16 patients:12 with esophageal achalasia (EA), 3 with jackhammer esophagus (JE), and 1 with esophagogastric junction outlet obstruction (EGJOO). The median procedure time was 91 (65–196) min, and the median muscle layer dissection was 8.0 (5–21) cm. There were no severe adverse events. Following the procedure, symptoms were significantly improved (Eckardt score, median 5.5→1.5, p = 0.005; F scale, median 21.0→11.0, p = 0.004). Two months later, high-resolution manometry was performed on 13 patients. In 9 cases of EA and 1 case of EGJOO, the median integrated relaxation pressure was significantly decreased (29.6→10.1 mmHg, p < 0.005). In 3 cases of JE, the median distal contractile integral was improved (8831.4→849.2 mmHg/s/cm).</p><p> (Conclusions) Initial experience at a single institution showed that POEM was feasible, safe, and appeared effective. Accumulation of cases and assessment of long-term outcomes would be desired.</p>

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