ASGE Endoscopy Live: Management of Achalasia | April 2023-Lecture - John Pandolfino Challenging Cases in Achalasia POEM

Lecture - John Pandolfino Challenging Cases in Achalasia POEM

Video Transcription

Video Summary

Dr. John Pandolfino from Northwestern University discusses challenging cases in treating achalasia with peroral endoscopic myotomy (POEM). He emphasizes the heterogeneity of achalasia presentations and the need for a precision approach to tailor therapy to individual patients. He highlights common mistakes in diagnosis, such as not recognizing the subtypes of EGJ outflow obstruction and the importance of understanding anatomy and the interplay of psychological distress in patient outcomes. Dr. Pandolfino also discusses the evolution of the Chicago classification system for achalasia and the use of functional luminal imaging probe (FLIP) to assess esophageal function. He emphasizes the need for standardizing FLIP protocols and the importance of considering multiple measurements, including diameter and distensibility index (DI), in evaluating treatment efficacy. He concludes by emphasizing the need for a comprehensive approach in managing achalasia patients, considering anatomy, physiology, and patient presentation.

Keywords

achalasia

peroral endoscopic myotomy

precision approach

EGJ outflow obstruction

Chicago classification system

functional luminal imaging probe