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Review
. 2017 Mar;9(Suppl 2):S130-S134.
doi: 10.21037/jtd.2016.09.39.

Per-oral endoscopic myotomy for achalasia

Steven R DeMeester  1
Affiliations
Review

Per-oral endoscopic myotomy for achalasia

Steven R DeMeester. J Thorac Dis. 2017 Mar.

Abstract

Symptoms in patients with achalasia are produced by outflow obstruction at the level of the lower esophageal sphincter (LES). As a consequence of neural destruction the LES does not undergo normal swallow-induced relaxation. In addition, the esophageal body loses normal peristaltic function and esophageal emptying is on the basis of gravity. All therapies for achalasia are palliative in that normal LES or esophageal body function cannot be restored. The efficacy of any therapy for achalasia is directly related to its ability to reduce the outflow obstruction at the LES. The three main treatment options are pneumatic dilatation, laparoscopic myotomy and partial fundoplication and per-oral endoscopic myotomy or per-oral esophageal myotomy (POEM). Details of the procedures and outcomes will be discussed.

Keywords: Achalasia; Botox; Heller myotomy; laparoscopic myotomy; per-oral endoscopic myotomy (POEM); pneumatic dilatation.

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Conflict of interest statement

Conflicts of Interest: The author has no conflicts of interest to declare.

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