Per-oral endoscopic myotomy for achalasia: An American perspective

作     者：David Friedel Rani Modayil Shahzad Iqbal James H Grendell Stavros N Stavropoulos 

作者机构：Department of GastroenterologyHepatology and Nutrition Winthrop University Hospital 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2013年第5卷第9期

页      面：420-427页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Per-oral endoscopic myotomy Achalasia Heller myotomy Natural orifice transluminal endoscopic surgery Per-oral endoscopic myotomy Minimally invasive surgery 

摘      要：Achalasia is an uncommon esophageal motility disorder characterized by the selective loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower esophageal ***-oral endoscopic myotomy(POEM) is a novel modality for the treatment of achalasia performed by gastroenterologists and *** represents a natural orifice transluminal endoscopic surgery(NOTES) approach to Heller *** has the minimal invasiveness of an endoscopic procedure that can duplicate results of the surgical Heller *** is conceptually similar to a surgical myotomy without the inherent external incisions and post-operative care associated with *** high success and low complications rates promise a great future for this *** fact,POEM has been successfully performed on patients with end-stage achalasia as an initial treatment reserving esophagectomy for those without good *** volume of POEMs performed worldwide has grown *** fact,surgeons who have performed Heller myotomy have embraced POEM as the preferred intervention for ***,the niche of POEM remains to be defined and long term results are *** describe our experience with POEM having performed the first POEM outside of Japan in 2009,the evolution of our technique,and give our perspective on its future.