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자료유형
학술저널
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대한소화기내시경학회 Clinical Endoscopy Clinical Endoscopy 제51권 제1호
발행연도
2018.1
수록면
13 - 18 (6page)

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초록· 키워드

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Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedurethat involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for thetreatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failedprior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensivemotor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to theesophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minorand self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations totunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastricperoral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases suchas achalasia with failed prior treatments, and hypertensive motor disorders.

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