Researchers at Gangnam Severance Hospital said Wednesday they have found that the peroral endoscopic myotomy (POEM) is effective in treating severe esophageal achalasia patients.

They analyzed the results of 13 achalasia patients who underwent POEM because of severe esophagus expansion and curvature caused by the disorder.

Achalasia is an esophageal motility disorder that incompletely loosened lower esophageal sphincter, a border region between the esophagus and stomach, and causes difficulties in patients swallowing food. As the disorder progresses, the esophagus turns into an S-shape as the lumen of the esophagus expands considerably, and the curvature of the esophagus intensifies.

S-shaped esophagus developed by severe achalasia patient

Drug treatment and endoscopic balloon dilation can be used initially, but severe achalasia patient with S-shaped esophagus often requires surgery because the existing method is not effective for them.

The research team, led by Professors Park Hyo-jin and Youn Young-hun at the hospital’s Gastroenterology Department, operated POEM instead of surgery on 13 S-shaped achalasia patients. It found every patient showed improvement in swallowing problems without developing complications. Eleven of them even saw improvement in the shape of their esophagus.

Esophagus of mild achalasia patient

"Recently, physicians operate minimally invasive surgery to reduce the recovery period and complication. Still, opening the abdomen or laparoscope is a burden that patients have to bear," Professor Park said. "We can try treating the patients by minimizing patients' burden as the POEM showed its efficacy."

Professor Youn added that achalasia patients are seven times more likely to develop esophagus cancer than healthy people because achalasia is a precancerous lesion. He also said that achalasia patients have to take endoscopic examination periodically and care for the prevention and early diagnosis.

The study was published in the latest issue of the Journal of Neurogastroenterology and Motility.

shim531@docdocdoc.co.kr

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