SAGES guidelines for the use of peroral endoscopic myotomy (POEM) for the treatment of achalasia

Geoffrey P Kohn^{1

2}, Rebecca C Dirks³, Mohammed T Ansari⁴, Jason Clay⁵, Christy M Dunst⁶, Lars Lundell^{7

8}, Jeffrey M Marks⁹, Daniela Molena¹⁰, Ceciel Rooker⁵, Payal Saxena^{11

12}, Lee Swanstrom¹³, Reuben K Wong¹⁴, Aurora D Pryor¹⁵, Dimitrios Stefanidis³

Affiliations

¹ Department of Surgery, Eastern Health Clinical School, Monash University, Clayton, VIC, Australia. gkohn@uppergi.net.
² Melbourne Upper GI Surgical Group, Melbourne, VIC, Australia. gkohn@uppergi.net.
³ Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
⁴ School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁵ International Foundation for Gastrointestinal Disorders, Mount Pleasant, USA.
⁶ The Oregon Clinic, Portland, OR, USA.
⁷ Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
⁸ Department of Surgery, Odense University Hospital, Odense, Denmark.
⁹ Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
¹⁰ Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
¹¹ AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Newtown, Sydney, NSW, Australia.
¹² Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
¹³ Institut de Chirugie, IHU Strasbourg, Strasbourg, France.
¹⁴ Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹⁵ Department of Surgery, Stony Brook University, Stony Brook, NY, USA.

PMID: 33564964
DOI: 10.1007/s00464-020-08282-0

Practice Guideline

SAGES guidelines for the use of peroral endoscopic myotomy (POEM) for the treatment of achalasia

Geoffrey P Kohn et al. Surg Endosc. 2021 May.

. 2021 May;35(5):1931-1948.

doi: 10.1007/s00464-020-08282-0. Epub 2021 Feb 9.

Authors

Affiliations

¹ Department of Surgery, Eastern Health Clinical School, Monash University, Clayton, VIC, Australia. gkohn@uppergi.net.
² Melbourne Upper GI Surgical Group, Melbourne, VIC, Australia. gkohn@uppergi.net.
³ Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
⁴ School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁵ International Foundation for Gastrointestinal Disorders, Mount Pleasant, USA.
⁶ The Oregon Clinic, Portland, OR, USA.
⁷ Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
⁸ Department of Surgery, Odense University Hospital, Odense, Denmark.
⁹ Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
¹⁰ Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
¹¹ AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Newtown, Sydney, NSW, Australia.
¹² Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
¹³ Institut de Chirugie, IHU Strasbourg, Strasbourg, France.
¹⁴ Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹⁵ Department of Surgery, Stony Brook University, Stony Brook, NY, USA.

PMID: 33564964
DOI: 10.1007/s00464-020-08282-0

Abstract

Background: Peroral endoscopic myotomy (POEM) is increasingly used as primary treatment for esophageal achalasia, in place of the options such as Heller myotomy (HM) and pneumatic dilatation (PD) OBJECTIVE: These evidence-based guidelines from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) intend to support clinicians, patients and others in decisions about the use of POEM for treatment of achalasia.

Results: The panel agreed on 4 recommendations for adults and children with achalasia.

Conclusions: Strong recommendation for the use of POEM over PD was issued unless the concern of continued postoperative PPI use remains a key decision-making concern to the patient. Conditional recommendations included the option of using either POEM or HM with fundoplication to treat achalasia, and favored POEM over HM for achalasia subtype III.

Keywords: Clinical practice guidelines; Esophageal achalasia; Heller myotomy; POEM procedure; Pneumatic dilatation.

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References

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SAGES guidelines for the use of peroral endoscopic myotomy (POEM) for the treatment of achalasia

Affiliations

SAGES guidelines for the use of peroral endoscopic myotomy (POEM) for the treatment of achalasia

Authors

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Abstract

References

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LinkOut - more resources

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