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- W2806988401 abstract "POEM (Per-oral endoscopic myotomy) has gained more and more popularity. In our hospital more than 1500 consecutive cases of achalasia and related disorders received POEM procedure in last 9 years. Short and middle term clinical results were satisfactory but potential risk of GERD after POEM was pointed out in some reports. Approximately 50% of POEM cases have reflux sign in 24hrs pH monitoring. In order to solve this potential disadvantage of POEM, endoscopic myotomy together with partial fundoplication (POEM+F) was developed and carried out as a pilot study (IRB approval number: 17T5010). Twelve consecutive cases with written informed consent received POEM+F. Right after completing myotomy, submucosal endoscope was advanced into peritoneal cavity. Pneumoperitoneum was achieved with CO2 insufflation through endoscope. Anterior wall of gastric fundus was grasped and anchored by 4 endoclips together with endoloop. Endoloop was fixed again to distal end of myotomy site by the other 3 endoclips (Figure 1). Endoloop was closed tightly under submucosal endoscopic visual control. Grasped anterior wall of gastric cardia was pulled up toward esophago-gastric junction. This traction created partial fundoplication at gastric cardia (Figure 2). POEM+F was successfully carried out in all cases. POEM+F created visually recognizable fundoplication at gastric cardia. Extended operating time was 36 minutes on average. Clinical course after POEM+F was uneventful. Hospital stay and dosage of pain controller was totally equal to conventional POEM procedure. 24hr pH impedance study of two months after POEM+F was carried out in 4 cases and no reflux was identified. POEM+F was technically feasible. In order to clarify anti-reflux effect of POEM+F needs to conduct RCT with large series. POEM+F is a pure NOTES procedure for esophageal achalasia." @default.
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- W2806988401 date "2018-06-01" @default.
- W2806988401 modified "2023-09-25" @default.
- W2806988401 title "Tu1145 PER-ORAL ENDOSCOPIC MYOTOMY FOLLOWED BY ENDOSCOPIC FUNDOPLICATION: A NOVEL PROCEDURE “POEM+F”" @default.
- W2806988401 doi "https://doi.org/10.1016/j.gie.2018.04.2175" @default.
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