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      Systematic review and meta-analysis: Efficacy and safety of POEM for achalasia

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          Abstract

          Peroral endoscopic esophageal myotomy (POEM) represents a less invasive alternative, as compared with conventional laparoscopic Heller myotomy for treating achalasia patients. In the last years, a number of prospective and retrospective experiences with POEM use for achalasia have been published.

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          Most cited references 48

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            The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration

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              Peroral endoscopic myotomy (POEM) for esophageal achalasia.

              Peroral endoscopic myotomy (POEM) was developed by our group to provide a less invasive permanent treatment for esophageal achalasia. POEM was performed in 17 consecutive patients with achalasia (10 men, 7 women; mean age 41.4 years). A long submucosal tunnel was created (mean length 12.4 cm), followed by endoscopic myotomy of circular muscle bundles of a mean total length of 8.1 cm (6.1 cm in distal esophagus and 2.0 cm in cardia). Smooth passage of an endoscope through the gastroesophageal junction was confirmed at the end of the procedure. In all cases POEM significantly reduced the dysphagia symptom score (from mean 10 to 1.3; P = 0.0003) and the resting lower esophageal sphincter (LES) pressure (from mean 52.4 mmHg to 19.9 mmHg; P = 0.0001). No serious complications related to POEM were encountered. During follow-up (mean 5 months), additional treatment or medication was necessary in only one patient (case 17) who developed reflux esophagitis (Los Angeles classification B); this was well controlled with regular intake of protein pump inhibitors (PPIs). The short-term outcome of POEM for achalasia was excellent; further studies on long-term efficacy and on comparison of POEM with other interventional therapies are awaited. Georg Thieme Verlag KG Stuttgart. New York.
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                Author and article information

                Journal
                United European Gastroenterology Journal
                United European Gastroenterology Journal
                SAGE Publications
                2050-6406
                2050-6414
                February 11 2015
                August 2015
                May 05 2015
                August 2015
                : 3
                : 4
                : 325-334
                Affiliations
                [1 ]Endoscopy Unit and Department of Surgery, Istituto Clinico Humanitas, Milan, Italy
                Article
                10.1177/2050640615581732
                4528214
                26279840
                © 2015

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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