Journal Review in Thoracic Surgery: POEM vs. Heller Myotomy

Want to learn more about achalasia and its procedural management? Excited about the POEM procedure?  Learn what the current literature says when it comes to recommending POEM or the tried-and-true Heller myotomy from the Swedish Thoracic surgery team.



Learning objectives

-        Review basics of achalasia

-        Discuss the current literature comparing POEM and Heller myotomy with fundoplication

-        Understand the major differences in outcomes for these procedures



Hosts:

Peter White, MD

Megan Lenihan, MD

Brian Louie, MD

Kelly Daus, MD



Referenced Material

Werner YB, Hakanson B, Martinek J, et al. Endoscopic or Surgical Myotomy in Patients with Idiopathic Achalasia. N Engl J Med. 2019 Dec 5;381(23):2219-2229. doi: 10.1056/NEJMoa1905380. PMID: 31800987.



Gu L, Ouyang Z, Lv L, et al. Safety and efficacy of peroral endoscopic myotomy with standard myotomy versus short myotomy for treatment-naïve patients with type II achalasia: a prospective randomized trial. Gastrointest Endosc. 2021 Jun;93(6):1304-1312. doi: 10.1016/j.gie.2020.10.006. Epub 2020 Oct 13. PMID: 33058884.



Shemmeri E, Aye RW, Farivar AS, Bograd AJ, Louie BE. Use of a report card to evaluate outcomes of achalasia surgery: beyond the Eckardt score. Surg Endosc. 2020 Apr;34(4):1856-1862. doi: 10.1007/s00464-019-06952-2. Epub 2019 Jul 8. PMID: 31286258.



Mota RCL, de Moura EGH, de Moura DTH, Bernardo WM, de Moura ETH, Brunaldi VO, Sakai P, Thompson CC. Risk factors for gastroesophageal reflux after POEM for achalasia: a systematic review and meta-analysis. Surg Endosc. 2021 Jan;35(1):383-397. doi: 10.1007/s00464-020-07412-y. Epub 2020 Mar 23. PMID: 32206921.



McKay SC, Dunst CM, Sharata AM, Fletcher R, Reavis KM, Bradley DD, DeMeester SR, Müller D, Parker B, Swanström LL. POEM: clinical outcomes beyond 5 years. Surg Endosc. 2021 Oct;35(10):5709-5716. doi: 10.1007/s00464-020-08031-3. Epub 2021 Jan 4. PMID: 33398572.



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