Ann D Smith, MD, MPH, Jaroslav Zivny, MD, Christopher A Marshall, MD, John J Kelly, MD. University of Massachusetts
Two major treatment modalities are available for patients with achalasia: a Heller Myotomy or a Per Oral Endoscopic Myotomy (POEM). The POEM was first discussed in the literature in 2009 and the steps for performing it were presented to IRCAD in 2012. A meta-analysis published in 2015 on the efficacy and safety of the POEM for achalasia included 551 patients with a 97% technical success rate. We present an experienced endoscopist in the early learning curve performing POEM with complications of bleeding and large injury to the gastric mucosa. Hemostasis was obtained and the defect was closed endoscopically. Patient intolerant to solids and so three weeks later a laparoscopic Heller Myotomy was performed with minimal difficulty despite significant POEM complications. Patient recovered well with excellent PO intake.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93497
Program Number: V087
Presentation Session: Flexible Endoscopy I
Presentation Type: Video