POEM (Per Oral Endoscopic Myotomy) is a non-invasive scarless surgery and has been a boon to curing achalasia cardia. The patients who suffer from this condition, where the food pipe muscles thicken and fail to relax, have difficulty in swallowing food.
Dr Philip Wai-yan Chiu, Professor, Department of Surgery at the Chinese University of Hong Kong, discussed about the complications and the intraoperative management involved in the procedure
At the 21st Mumbai Live Endoscopy 2018, Dr Philip Wai-yan Chiu, Professor, Department of Surgery at the Chinese University of Hong Kong, briefed about the Peroral Endoscopic Myotomy (POEM) procedure, a therapy for achalasia that is safe and effective, particularly when considering the limitations of the other available surgical and non-surgical options.
“POEM procedure was performed for the treatment of achalasia. It was developed and performed for the first time in Japan in 2009. It is the extension of ESD procedure,” said Dr Chiu.
He added, “This procedure is done without any surgical incision. In literature, currently there are many publications about the clinical efficacy of POEM. Through this, the symptomatic relief rate is more than 97 per cent. Usually, complications related to POEM procedure are not significant.”
Dr Amit Maydeo, the director of the Baldota Institute of Digestive Sciences, Global Hospital and Course Chairman of Mumbai Live Endoscopy 2018, who is the first to start this procedure in India, said in Mumbai, 200 to 300 cases of achalasia cardia are reported every year.
“I started performing this procedure since October 2012. Then, we thought achalasia cardia is rare. Earlier, we used to have one case in 2.5 lakh people; it has gone up to about 10 in 1 lakh people. Many even go unreported,” he said.
Dr Maydeo cautioned that ‘not being able to swallow’ should be treated as an alarm as it can be a symptom of cancer. “We do not know the exact reason of achalasia cardia but if not treated on time, 7 to 8 per cent of cases can progress to food pipe cancer,” he said.