PEP: panesophageal pressurization; LES: lower esophageal sphincter; ASA: American Society of Anesthesiologists; GERD: gastroesophageal reflux disease; POEM: peroral endoscopic myotomy; SL: sublingual.
* The preprocedure evaluation includes a medical history, anesthesia-directed physical examination, and assessing ASA physical status. Refer to UpToDate content on anesthesia for gastrointestinal endoscopy for details.
¶ Higher rates of GERD are reported after POEM than either laparoscopic myotomy or pneumatic dilation. This may be a consideration for younger patients and for those who do not want long-term therapy with a proton pump inhibitor.
Δ The length of the myotomy can be tailored to the length of the spastic esophageal segment as demonstrated on diagnostic studies (eg, high resolution manometry, functional lumen imaging probe).Do you want to add Medilib to your home screen?