Long-Term Safety and Efficacy of Peroral Endoscopic Myotomy for Achalasia

This treatment option should be discussed with all patients with achalasia.

Use of peroral endoscopic myotomy (POEM) has been shown to be safe and effective for treatment of achalasia, but only in short-term, single-center studies.

In an international retrospective review, investigators in tertiary care centers evaluated the long-term safety and efficacy of standard POEM for achalasia in 205 patients who had a minimum follow-up of 2 years. Median follow-up was 31 months.

Results were as follows:

Rates of clinical success (defined by validated Eckardt scores) at 6, 12, and ≥24 months were 98%, 98%, and 91%, respectively.
POEM was performed after failure of another treatment in 40%.
For those with clinical response at 6 months, only 6% had recurrent symptoms at 2 years.
Prior pneumatic dilation was a predictor of long-term…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors