Poetry is in the air: First multi-institutional results of the per-oral endoscopic myotomy procedure for achalasia

摘要

So what is there not to like about POEM? It is as fast to perform as a laparoscopic Heller, with better early results than a Heller myotomy, balloon dilation, or Botox, and a recovery typical of a surgical or endoscopic treatments. In short: Surgical efficacy with the recovery profile of an endoscopy. Certainly 1 issue of concern is the decrease in efficacy noted over the course of the first year in this registry experience—from 97% at 3 months to 83% at 12 months—a somewhat worrisome trend. One suspects that this may be a factor of the multicenter nature of this study, where some centers had relatively little prior exposure to the procedure. In fact, this late recurrence phenomenon has not been reported in the larger, single-center series published to date, several with follow-up of 2-3 years.