Kim Hak Su, Kim Hee Kyung, Ko Weon Jin
Department of Gastroenterology and Hepatology, Incheon Sarang Hospital, Incheon, Korea.
Department of Gastroenterology and Hepatology, Cheonggu Sungsim Hospital, Seoul, Korea.
Clin Endosc. 2020 Mar;53(2):232-235. doi: 10.5946/ce.2019.067. Epub 2019 Jul 16.
Peroral endoscopic myotomy (POEM) has been recently considered as the first treatment option for achalasia. The standard POEM procedures are often successful in most patients, but sometimes technical challenges are encountered. We report a new technique that is divided between two tunneling sites in the esophagus for sigmoid-type achalasia. A 40-year-old male patient with dysphagia for 10 years was diagnosed with a sigmoid-shaped esophagus at our hospital. We devised a two-stage myotomy technique to treat sigmoidtype achalasia. The myotomy was first performed in the upper part of the greater flexion area and then in the lower part of the flexion. We termed this method "two-stage POEM", which was successfully performed without any complications. This new POEM method can also be used to improve symptoms in patients with achalasia who have a structural deformity that may result in a high change of treatment failure.
经口内镜下肌切开术（POEM）最近被视为贲门失弛缓症的首选治疗方法。标准的POEM手术在大多数患者中通常是成功的，但有时会遇到技术挑战。我们报告一种新技术，该技术用于乙状结肠型贲门失弛缓症，在食管的两个隧道部位之间进行划分。一名40岁男性患者，吞咽困难10年，在我院被诊断为乙状结肠型食管。我们设计了一种两阶段肌切开术技术来治疗乙状结肠型贲门失弛缓症。肌切开术首先在大弯区上部进行，然后在弯曲下部进行。我们将这种方法称为“两阶段POEM”，该方法成功实施且无任何并发症。这种新的POEM方法还可用于改善贲门失弛缓症患者的症状，这些患者存在结构畸形，可能导致治疗失败的高风险。
