| Theme | Technological Innovation of Digestive Endoscopy -- Toward the Next Generation of Endoscopic Medicine | |
|---|---|---|
| Title | Development of POEM (Per—Oral Endoscopic Myotomy) for Esophageal Achalasia and POET (Per—Oral Endoscopic Tumor Resection) for Submucosal Tumor | |
| Publish Date | 2016/09 | |
| Author | Haruhiro Inoue | Digestive Disease Center, Showa University Koto Toyosu Hospital |
| Author | Hitomi Minami | Gastroenterology and Hepatology, Nagasaki University Hospital |
| Author | Haruo Ikeda | Digestive Disease Center, Showa University Koto Toyosu Hospital |
| Author | Manabu Onimaru | Digestive Disease Center, Showa University Koto Toyosu Hospital |
| [ Summary ] | The first clinical case of POEM (per‒oral endoscopic myotomy) for esophageal achalasia was performed on September 8, 2008. POEM is a type of NOTES (natural orifice transluminal endoscopic surgery) which enables completion of endoscopic Heller myotomy. A major advantage of POEM compared to laparoscopic Heller myotomy is the ease of extending the myotomy length. POEM has been performed in more than 1,100 cases in Showa University. None of the patients had serious complications (Clavien‒Dindo iiib or more). Success rate was approximately more than 97 % (Eckardt score <3). As an offshoot of POEM, POET resection was developed and performed successfully. The best indication is a less than 4 cm leiomyoma of the esophagus and esophago‒gastric junction. Technical details of POEM and POET are based on the technical and instrumental development of ESD (endoscopic submucosal dissection). | |