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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

MEJIA M., Ricardo et al. Per-oral endoscopic myotomy (POEM) for the treatment of achalasia. Initial clinical experience and short term results. Rev Chil Cir [online]. 2017, vol.69, n.5, pp.429-434. ISSN 0718-4026.  http://dx.doi.org/10.1016/j.rchic.2017.03.004.

Introduction:

Achalasia is the most common primary motor disorder of the esophagus. The current standard of treatment is laparoscopic Heller's myotomy. Recently the development of advanced endoscopic techniques has allowed the positioning of the POEM (per-oral endoscopic myotomy) technique as a new therapeutic alternative with promising results.

Objective:

To present our clinical experience in POEM, with description of the technique used, peri-operative results and short-term follow-up in the development of this therapeutic alternative.

Materials and methods:

We performed a retrospective analysis of data obtained prospectively from 15 patients undergoing POEM in three clinical centers in our country. Preoperative demographic variables, intraoperative detail, and operative morbidity and mortality were collected. Clinical follow-up was performed with controls recording Eckardt score and presence of gastroesophageal reflux symptoms.

Results:

Between August 2015 and November 2016, 15 POEM were performed, six of these patients were women, average age was 49 years. The average operative time was 110 min, we did not have any perioperative morbimortality. Hospital stay was 2.8 days. Follow-up was between 1 and 15 months, Eckardt's preoperative and postoperative score was on average 10.5 and 0.4 points, respectively. Three patients had gastroesophageal reflux symptoms at the time of follow-up.

Conclusion:

Our results support the effectiveness and security of POEM in short-term follow up. Further monitoring is required to determine the definitive role of this technique.

Palabras clave : Achalasia; Upper gastrointestinal endoscopy; Myotomy.

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