Clin Endosc.  2020 Mar;53(2):232-235. 10.5946/ce.2019.067.

Two-Stage Peroral Endoscopic Myotomy for Sigmoid-Type Achalasia

Affiliations
  • 1Department of Gastroenterology and Hepatology, Incheon Sarang Hospital, Incheon, Korea
  • 2Department of Gastroenterology and Hepatology, Cheonggu Sungsim Hospital, Seoul, Korea
  • 3Department of Gastroenterology, CHA Kumi Medical Center, Gumi, Korea

Abstract

Peroral endoscopic myotomy (POEM) has been recently considered as the first treatment option for achalasia. The standard POEM procedures are often successful in most patients, but sometimes technical challenges are encountered. We report a new technique that is divided between two tunneling sites in the esophagus for sigmoid-type achalasia. A 40-year-old male patient with dysphagia for 10 years was diagnosed with a sigmoid-shaped esophagus at our hospital. We devised a two-stage myotomy technique to treat sigmoidtype achalasia. The myotomy was first performed in the upper part of the greater flexion area and then in the lower part of the flexion. We termed this method “two-stage POEM”, which was successfully performed without any complications. This new POEM method can also be used to improve symptoms in patients with achalasia who have a structural deformity that may result in a high change of treatment failure.

Keyword

Esophageal achalasia; Esophageal motility disorders; Myotomy; Peroral endoscopic myotomy
Full Text Links
  • CE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2020 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr