Per-oral endoscopic myotomy (POEM): Its complications and beyond

Abstract

 Since the concept of natural orifice transluminal endoscopic surgery (NOTES) was introduced, per oral endoscopic myotomy (POEM) has been one of the most successful and widely-accepted procedures. Evidence from many studies suggests that POEM can achieve the same improvement in symptoms as laparoscopic Heller myotomy, but in a less invasive fashion. To date, no mortality has been reported, and the incidence of complications has been minimal. Most complications can be easily managed by non-surgical treatment, and many can be avoided by technical improvement of the operators. In this review, we describe the indications, technique, efficacy and complications of the POEM procedure. POEM for non-achalasia spastic disorders is also discussed.

Keywords: Achalasia, diffuse esophageal spasm, nutcracker esophagus, Jackhammer esophagus, hypertensive lower esophageal sphincter, per-oral endoscopic myotomy