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Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2116-2126
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2116
Peroral endoscopic myotomy for management of gastrointestinal motility disorder
Zhe Feng, Zi-Ming Liu, Xiang-Lei Yuan, Lian-Song Ye, Chun-Cheng Wu, Qing-Hua Tan, Bing Hu
Zhe Feng, Zi-Ming Liu, Xiang-Lei Yuan, Lian-Song Ye, Chun-Cheng Wu, Qing-Hua Tan, Bing Hu, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Feng Z generated the figures and wrote the manuscript; Liu ZM, Yuan XL, Ye LS, Wu CC, and Tan QH contributed to the writing of the manuscript; Hu B designed the aim of the editorial and wrote the manuscript.
Conflict-of-interest statement: Prof. Bing Hu is one of the inventors of the O-POEM, D-O-POEM, and dual-POEM. The authors disclose no conflicts of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Bing Hu, MD, Chief Doctor, Professor, Department of Gastroenterology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. hubingnj@163.com
Received: January 6, 2020
Peer-review started: January 6, 2020
First decision: February 26, 2020
Revised: March 27, 2020
Accepted: April 28, 2020
Article in press: April 28, 2020
Published online: June 6, 2020
Abstract

Achalasia is a type of esophageal motility disorder, consisting of relaxation dysfunction of the lower esophagus and disturbed esophageal peristalsis. Related clinical symptoms include dysphagia, regurgitation, chest pain, and weight loss. Traditional treatment options include endoscopic botulinum toxin injection, endoscopic pneumatic dilation, and laparoscopic Heller’s myotomy. These therapies mainly relieve symptoms by reducing the pressure on the lower esophageal sphincter and reducing blood flow resistance at the esophagogastric junction. Based on endoscopic submucosal dissection and natural orifice transluminal endoscopic surgery, peroral endoscopic myotomy (POEM) is a purely endoscopic method of myotomy with minimal invasiveness and a low rate of adverse events when performed by experienced operators. Since then, numerous studies have shown the significant clinical efficacy and safety of POEM. The purpose of this article is to introduce different modified POEMs, special indications for different POEMs, and their advantages as well as disadvantages.

Keywords: Endoscopy, Achalasia, Peroral endoscopic myotomy, Esophageal diverticula, Gastroparesis, Pyloric stenosis

Core tip: There are several articles in the literature introducing some specific peroral endoscopic myotomies (POEM). However, this is the first minireview to report most of the modified POEM and to compare the advantages and disadvantages of them as well as their special indications. In addition, this article not only focuses on the application of POEM in achalasia, but also includes the treatment of esophageal diverticulum, gastroparesis, and pyloric stenosis.