ASGE Peroral Endoscopic Myotomy (POEM) Pearls to Practice: (On-Demand) | July 2022-Pandolfino

Pandolfino_ASGE POEM Case 7-16-22

Pdf Summary

This document provides a summary of various topics related to Achalasia, including the classification and treatment options for the condition. The document includes case studies, discussion on post-POEM complications, and potential modifications to the treatment approach.<br /><br />Achalasia: The document emphasizes that Achalasia is now better defined due to high-resolution manometry, which allows for a more accurate assessment of impaired relaxation and esophagogastric junction (EGJ) opening and anatomy. The document describes different subtypes of Achalasia and recommends tailoring therapy based on individual patients.<br /><br />Post-POEM Complications: The document discusses potential complications after peroral endoscopic myotomy (POEM) and suggests that modifying the myotomy approach may reduce the risk of complications such as blown-out myotomy (BOM) and gastroesophageal reflux disease (GERD).<br /><br />GERD and Hernia: The document highlights the importance of assessing and managing GERD symptoms in patients after treatment for Achalasia. It suggests trying medical therapy with proton pump inhibitors (PPIs) first and considering further interventions if there is a poor response. The presence of a hernia may also impact treatment decisions.<br /><br />Predicting Outcomes: The document mentions the use of various tools, such as Eckardt score, esophagogastric junction opening parameters, and in-silico models, to predict outcomes and guide treatment decisions in patients with Achalasia.<br /><br />Overall, the document provides a comprehensive overview of different aspects of Achalasia, including classification, treatment options, post-treatment issues, and predicting outcomes. It emphasizes the importance of individualized and tailored therapy for better management of the condition.

Keywords

Achalasia

classification

treatment options

high-resolution manometry

impaired relaxation

subtypes

post-POEM complications

GERD

hernia

predicting outcomes