Armando Rosales, MD, Tymothy A Woodward, MD, Steven P Bowers, MD. Mayo Clinic Florida
Introduction: Recurrent or persistent symptoms after Heller myotomy occur in approximately 10-20% of patients. Per-Oral Endoscopy Myotomy (POEM) is a possible treatment modality available to avoid a reoperation at the gastroesophageal junction in patients with failed Heller myotomy (HM). POEM can be technically successful in approximately 98% and with 81% clinical response in patients with prior HM.
Methods: Our patient is a 56-yo F with multiple foregut surgeries, she presented to clinic with distal esophageal spasms and heartburn. Preoperative pH manometry was consistent with esophageal stasis. Upper gastrointestinal showed an anterior diverticulum. Patient underwent a POEM of posterior wall.
Results: The procedure was uneventful. Adequate posterior wall circular muscle myotomy was accomplished up to the gastroesophageal junction. Postoperatively, the upper gastrointestinal image studies did not revealed a leak, and showed adequate passage of contrast. Currently, doing well.
Conclusion: In order to avoid a reoperation, POEM of posterior wall is an acceptable and safe procedure
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95214
Program Number: V208
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop