Treatment introduction
he most evident clinical treatment is surgery (Heller's myotomy), compared with pneumatic dilation or botulism injection, the effect persists longer. The operation opens an abdominal or chest wall incision, locating the lower oesophagal sphincter to make a longitudinal muscular incision (myotomy) about 9~12 centimetres in length. Surgery could also be performed laparoscopically.
Per-oral endoscopic myotomy (POEM) is a new technically demanding procedure. It is done with the use of a gastroscope by an experienced endoscopist. When the gastroscope is inserted into the lower oesophagus, it will make a small incision, and then the gastroscope will be inserted into the underlying submucosal layer. Myotomy is then performed.
Compared with conventional surgery, POEM has a smaller mucosal wound, lower infection rate, shorter operative time, and shorter hospital stay. POEM provides a safer alternative for the treatment of achalasia.
Features
Compared with conventional surgery, a feature of Per-Oral Endoscopic Myotomy (POEM) is smaller mucosal wounds without a cutaneous skin incision, which allows for shorter operation time and shorter hospital stay.