초록 열기/닫기 버튼
Achalasia is a neurodegenerative motility disorder caused by enteric neuron damage in the lower esophageal sphincter. Peroralendoscopic myotomy (POEM) is a standard treatment method for achalasia. Previous treatment modalities may affect theoutcome of POEM as they cause submucosal fibrosis. We report a new technique called “hybrid POEM” for the treatment ofpatients with achalasia who had been previously treated with pneumatic balloon dilatation. We performed two techniques ofPOEM simultaneously, the standard POEM for the upper part of the submucosal tunnel and open POEM for the stenotic part ofthe esophagogastric junction. We dissected the mucosa and submucosa, and performed myotomy simultaneously. We overcamesubmucosal fibrosis of the esophagogastric junction, which was caused by the previous hybrid POEM treatment. The risks ofmucosal incision and technical challenge of submucosal tunneling for the fibrotic area may be reduced by hybrid POEM.
