Peroral Endoscopic Myotomy Is Safe and Effective in Octogenarians

Older age and comorbidities were not obstacles to successful POEM therapy for achalasia at expert centers.

Although the adverse event rates reported for peroral endoscopic myotomy (POEM) for treatment of achalasia have been amazingly low, consensus recommendations do not support its use as first-line therapy in elderly patients. In one previous report, more than 60% of patients aged ≥75 years with achalasia were left untreated, presumably because of high perceived risk for procedure-related adverse events.

To investigate the safety and efficacy of POEM in patients aged ≥80 years, researchers from eight tertiary referral centers (with recognized high-volume POEM expertise) analyzed data on 76 consecutive patients aged ≥80 years (mean age, 84 ±3.2 years). Forty-two percent of patients were treatment naive, 45% had prior pneumatic dilation, and 32% …

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