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POEM: Pre-procedural Work-Up and Indications

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Gastrointestinal Interventional Endoscopy

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Abstract

Peroral endoscopic myotomy (POEM) is a transluminal endoscopic procedure which dissects the lower esophageal sphincter via access obtained through a submucosal tunnel. The procedure was first developed as a treatment for achalasia, but its indications have quickly spread. In addition to all the clinical subtypes of achalasia, its indications now include a subset of patients with esophagogastric junction outflow obstruction, distal esophageal spasm, jackhammer esophagus, and as retreatment following prior achalasia therapy. Current clinical practice suggests that the minimum work-up required prior to POEM should include upper endoscopy and high-resolution manometry. Here we review the growing body of literature regarding indications for POEM and the appropriate work-up including advanced diagnostic testing to identify those patients who are most likely to benefit from LES targeted therapy.

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Authors and Affiliations

  1. Section of Gastroenterology and Hepatology in the Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Joseph Rayfield Triggs

  2. Division of Gastroenterology, Department of Medicine, Northwestern University’s Feinberg School of Medicine, Chicago, IL, USA

    John E. Pandolfino

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  1. Joseph Rayfield Triggs
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  2. John E. Pandolfino
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Correspondence to John E. Pandolfino .

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Editors and Affiliations

  1. Interventional Endoscopy, Division of Gastroenterology, University of Colorado-Denver, Aurora, CO, USA

    Mihir S. Wagh

  2. Interventional Endoscopy, Division of Gastroenterology, University of Colorado-Denver, Aurora, CO, USA

    Sachin B. Wani

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Triggs, J.R., Pandolfino, J.E. (2020). POEM: Pre-procedural Work-Up and Indications. In: Wagh, M., Wani, S. (eds) Gastrointestinal Interventional Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-21695-5_17

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  • DOI: https://doi.org/10.1007/978-3-030-21695-5_17

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