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    With the development of endoscopic interventions and inspired by the success of peroral endoscopic myotomy (POEM) for the treatment of achalasia, we investigated an old method of direct peroral endoscopic myotomy without a submucosal tunnel for the treatment of achalasia, which we call open peroral endoscopic myotomy (O-POEM). In this study, Clinical success was achieved in the patient after O-POEM. A reduction of LES pressure, Eckardt score, and a timed barium esophagogram were observed during follow-up. There were no severe complications and no recurrences during two months of follow-up. Therefore, open peroral endoscopic myotomy is a feasible and effective endoscopic treatment modality for achalasia. However, long-term outcomes of O-POEM requires further follow-up.
    Endoscopic treatment
    Citations (21)
    Peroral endoscopic myotomy (POEM) is now the established modality of choice for achalasia cardia with good long-term efficacy [1]. Dislodgement of the distal attachment (hood) inside the tunnel is an uncommon intraoperative event. The retrieval of a dislodged hood can be troublesome at or beyond the lower esophageal sphincter (LES). Here we share a case of POEM for achalasia cardia where the patient developed a dual problem of a type II mucosal injury and dislodgement of the hood at the level of the LES that was tackled with myotomy.
    Esophageal sphincter
    Citations (0)
    Peroral endoscopic myotomy (POEM) is a revolutionary therapy for achalasia and related disorders. POEM utilizes almost the same myotomy procedure as the Heller myotomy; thus, it would be expected to have the same or greater duration of therapeutic effect. However, to date, there have been no reports to prove the basis for this procedure in achalasia. In this case, we were able to histologically show the divided muscle after POEM since the patient had an esophagectomy for esophageal cancer. Histology showed that the muscle tissue divided by the POEM procedure was completely replaced by fibrosis. These findings may indirectly show the permanence of the POEM procedure.
    Esophagectomy
    Citations (3)