Endoscopic Myotomy for the Treatment of Achalasia (Motility Disorder) of the Esophagus - POEM Procedure
| Status: | Completed |
|---|---|
| Conditions: | Gastrointestinal |
| Therapuetic Areas: | Gastroenterology |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 3/16/2015 |
| Start Date: | February 2012 |
| End Date: | April 2015 |
| Contact: | Deborah J McGrath, RN |
| Email: | DMCGRATH@PARTNERS.ORG |
| Phone: | 617-724-4091 |
Endoscopic Esophageal Myotomy for the Treatment of Achalasia
Endoscopic Esophageal Myotomy (POEM), the research procedure, splits the lower esophageal
sphincter muscle fibers from the inside of the esophagus, avoiding several abdominal
incisions (belly area cuts), by using an endoscope to create a small cut at the most inner
layer of the esophagus to expose the esophageal sphincter muscle fibers from the inside of
the esophagus. The investigators are studying whether subjects who undergo Endoscopic
Esophageal Myotomy will have similar functional outcome, and at the same time less pain,
scar formation and wound infection than with laparoscopic or open surgery.
sphincter muscle fibers from the inside of the esophagus, avoiding several abdominal
incisions (belly area cuts), by using an endoscope to create a small cut at the most inner
layer of the esophagus to expose the esophageal sphincter muscle fibers from the inside of
the esophagus. The investigators are studying whether subjects who undergo Endoscopic
Esophageal Myotomy will have similar functional outcome, and at the same time less pain,
scar formation and wound infection than with laparoscopic or open surgery.
The purpose of this research study is to find out more about a less invasive way of doing
the surgical procedure (esophageal myotomy) to treat Achalasia.
Achalasia is a disease of the esophagus, where the lower esophageal sphincter fails to
relax, causing difficulty in swallowing.
Esophageal myotomy (Heller myotomy) is surgically cutting the muscle fibers of the
esophageal sphincter to allow passage of food into the stomach.
Esophageal myotomy is routinely done either by laparoscopic or open surgery. Laparoscopic
surgery requires several (about 4 to 5) small incisions in the abdomen to allow the camera
and surgical instruments to be introduced into the abdominal cavity to perform the myotomy.
In open surgery, a 6- to 8-inch abdominal incision is made to gain access to the abdominal
cavity to perform the myotomy.
Endoscopic Esophageal Myotomy (POEM), the research procedure, splits the lower esophageal
sphincter muscle fibers from the inside of the esophagus, avoiding several abdominal
incisions.
The researchers are investigating how safe Endoscopic Esophageal Myotomy is and how well it
works. Additionally, the researchers will assess the level of pain and the amount of
scarring subjects has after this surgery.
the surgical procedure (esophageal myotomy) to treat Achalasia.
Achalasia is a disease of the esophagus, where the lower esophageal sphincter fails to
relax, causing difficulty in swallowing.
Esophageal myotomy (Heller myotomy) is surgically cutting the muscle fibers of the
esophageal sphincter to allow passage of food into the stomach.
Esophageal myotomy is routinely done either by laparoscopic or open surgery. Laparoscopic
surgery requires several (about 4 to 5) small incisions in the abdomen to allow the camera
and surgical instruments to be introduced into the abdominal cavity to perform the myotomy.
In open surgery, a 6- to 8-inch abdominal incision is made to gain access to the abdominal
cavity to perform the myotomy.
Endoscopic Esophageal Myotomy (POEM), the research procedure, splits the lower esophageal
sphincter muscle fibers from the inside of the esophagus, avoiding several abdominal
incisions.
The researchers are investigating how safe Endoscopic Esophageal Myotomy is and how well it
works. Additionally, the researchers will assess the level of pain and the amount of
scarring subjects has after this surgery.
Inclusion Criteria:
- Diagnosis of achalasia
- Age 18-65
- ASA class 1-2
Exclusion Criteria:
- Pregnant women
- Any prior surgical or endoscopic treatment for achalasia except dilation less than 20
mm
- Patients who are taking immunosuppressive medications or are immunocompromised
Patients on blood thinners or aspirin or with history of bleeding disorders
- ASA class III patients
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