• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Multicenter collaborative retrospective review of peroral endoscopic myotomy for esophageal achalasia; examination of more than 1,300 cases at 8 facilities in Japan

Multicenter collaborative retrospective review of peroral endoscopic myotomy for esophageal achalasia; examination of more than 1,300 cases at 8 facilities in Japan

Hironari Shiwaku1, Haruhiro Inoue2, Manabu Onimaru2, Hitomi Minami3, Hiroki Sato4, Chiaki Sato5, Shinwa Tanaka6, Ryo Ogawa7, Norihiko Okushima8. 1Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, 2Digestive Diseases Center, Showa University Koto-Toyosu Hospital, 3Department of Gastroenterology and Hepatology, Nagasaki University Hospital, 4Division of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, 5Division of Advanced Surgical Science and Technology, Tohoku University School of Medicine, 6Department of Gastroenterology, Kobe University Hospital, 7Department of Gastroenterology, Faculty of Medicine, Oita University, 8Heart Life Hospital

Introduction: Peroral endoscopic myotomy (POEM) is revolutionary treatment for esophageal achalasia. Since Inoue et al. reported the first use of POEM in 2008, many cases have been reported worldwide, but there are few studies including more than 1000 cases. We report the outcome of POEM at 8 facilities in Japan.

Aim: To review the results and adverse effects of POEM performed for achalasia between September 2008 and July 2017 at 8 facilities in Japan.

Methods: Follow-up data after POEM was gathered within 3 months postoperatively by medical interview, endoscopic examination, and manometry. The same evaluations were repeated annually. To assess the safety of the procedure, we evaluated adverse events using the Clavian-Dindo classification.

Results: During the decade under review, 2164 POEM procedures were performed, for which adequate information was available for detailed review in 1307 cases.

The achalasia was the straight type in 1053 cases (80%), sigmoid type in 238 cases (18%), and related disorders in 16 cases (2%). The average patient age was 51.0 years (range 3–95 years); 711 (54%) were males and 596 (46%) were females. Previous treatment included balloon dilatation in 30% and surgery in 3%. The average operation time was 100 minutes. The mean total length of myotomy was 14 cm, extending into the stomach a mean of 3 cm. The pressure of the lower esophageal sphincter was reduced from a mean of 41.3 mmHg to 18.2 mmHg, a significant difference between pre- and postoperative values. The response rate (Eckardt score ? 3 or less) was 95.2%. We noted 50 adverse events (3.8%) of grade IIIa or less, but all were alleviated with conservative treatment. There were no grades IIIb or greater adverse events. After POEM, erosive esophagitis according to the Los Angeles classification was not present in 36%, grade A in 34%, B in 24%, C in 6%, and D in 0%. In addition, symptomatic GERD after POEM was confirmed in 16%. However, both erosive esophagitis and symptomatic GERD responded to treatment with a proton pump inhibitor (PPI).

Conclusion: In this study of more than 1,000 cases, the outcome of POEM for achalasia was good. No serious adverse events occurred, and about GERD after POEM, no cases were refractory to treatment with PPI . POEM is a safe and effective treatment for esophageal achalasia.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87418

Program Number: S088

Presentation Session: Plenary 1 Session

Presentation Type: Podium

37

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals