PDF(Pubmed)
Abstract：
Our review delves into the realm of peroral endoscopic myotomies (POEMs) in the upper gastrointestinal tract (UGT). In recent years, POEMs have brought about a revolution in the treatment of UGT motility disorders. Esophageal POEM, the first to be introduced, has now been validated as the primary treatment for achalasia. Subsequently developed, G-POEM displays promising results in addressing refractory gastroparesis. Over time, multiple endoscopic myotomy techniques have emerged for the treatment of Zenker\'s diverticulum, including Z-POEM, POES, and hybrid approaches. Despite the well-established efficacy outcomes, new challenges arise in the realm of POEMs in the UGT. For esophageal POEM, the future scenario lies in customizing the myotomy extent to the minimum necessary, while for G-POEM, it involves identifying patients who can optimally benefit from the treatment. For ZD, it is crucial to validate an algorithm that considers various myotomy options according to the diverticulum\'s size and in relation to individual patients. These challenges align with the concept of precision endoscopy, personalizing the technique for each subject. Within our text, we comprehensively examine each myotomy technique, analyzing indications, outcomes, and adverse events. Additionally, we explore the emerging challenges posed by myotomies within the context of the evolving field of precision endoscopy.
摘要：
我们的评论深入研究了上消化道（UGT）的经口内镜肌切开术（POEM）领域。近年来,POEM在治疗UGT运动障碍方面带来了革命。食管POEM,第一个被介绍的，现已被验证为贲门失弛缓症的主要治疗方法。后来发展起来的,G-POEM在解决难治性胃轻瘫方面显示出有希望的结果。随着时间的推移,已经出现了多种内镜下肌切开术技术来治疗Zenker憩室，包括Z-POEM，POES,和混合方法。尽管疗效结果已经确立，UGT中的POEM领域出现了新的挑战。对于食道POEM，未来的情况在于将肌肉切开术的范围定制到必要的最低限度，而对于G-POEM，它涉及确定可以从治疗中最佳受益的患者。对于ZD,根据憩室的大小和个体患者的关系，验证考虑各种肌切开术选项的算法是至关重要的。这些挑战与精密内窥镜的概念相一致，个性化每个主题的技术。在我们的文本中，我们全面检查了每种肌切开术，分析适应症，结果，和不良事件。此外,我们在精密内窥镜检查领域的发展背景下探讨了肌切开术带来的新挑战。
