ASGE Postgraduate Course at ACG 2022: Expanding the Scope of Fundamental and Advanced Endoscopy | October 2022-State of the Art Lecture: The POEM Alphabet

Video Transcription

Video Summary

In this video, Dr. Dennis Yang discusses various endoscopic procedures related to the gastrointestinal (GI) tract. He starts by explaining the concept of the "poem alphabet," which represents different procedures that have emerged in the field of endoscopy. He focuses on three main procedures: esophageal poem, gastroparesis poem (gpoem), and Zanker's diverticulum poem (zpoem).<br /><br />Dr. Yang highlights that esophageal poem is a successful procedure for treating esophageal dysmotility. Multiple centers worldwide have reported sustained clinical response rates ranging from 80% to 95%. Studies have also shown its superiority over other treatment modalities such as pneumatic balloon dilation. Reflux is a common concern after poem, but it can be managed with proton pump inhibitors (PPIs) and is not significantly different from surgical myotomy.<br /><br />Regarding gpoem for gastroparesis, the outcomes are less impressive than esophageal poem due to the complexity and heterogeneity of gastroparesis as a condition. However, a recent study showed superior clinical response with gpoem compared to a sham control. Further studies are needed to confirm these findings.<br /><br />In the case of Zanker's diverticulum, endoscopic therapies such as zpoem and septotomy have been effective alternatives to traditional surgical procedures. Dr. Yang explains that zpoem is a technically challenging procedure, and modified techniques, such as non-injection zpoem, have shown promising results. However, more data and longer-term follow-up are needed.<br /><br />Dr. Yang concludes by emphasizing the importance of using well-defined indications for these procedures and being cautious in interpreting the results of small observational studies. He reminds practitioners to stay informed about the evolving field of endoscopy and to consider the efficacy, safety, and long-term outcomes when deciding on treatment options.<br /><br />Credits: The video features Dr. Dennis Yang, who is affiliated with AdventHealth Orlando, and was shared by Peter Cotton, James Buxbaum, and Alisma Mujica.

Asset Subtitle

Dennis J. Yang, MD, FASGE, FACG

Keywords

endoscopic procedures

gastrointestinal tract

esophageal poem

gastroparesis poem

Zanker's diverticulum poem