Abstract：
OBJECTIVE: POEM is a mature procedure endorsed by societal guidelines as a first line therapy for achalasia and spastic esophageal disorders. Nonetheless, several questions remain, including expanding indications for POEM, periprocedural evaluation and management, and the optimal POEM technique to enhance clinical success while mitigating risk for reflux.
RESULTS: There is uncertainty regarding several technical aspects of the POEM myotomy; though aggregating evidence supports the use of real-time impedance planimetry to guide the myotomy. While post-POEM reflux remains a concerning long term sequela, there is an increasing focus on the potential role of endoscopic anti-reflux interventions. Lastly, with the widespread adoption of POEM, we continue to witness ongoing efforts to standardize post-procedural care and training in this procedure. POEM is no longer a novel but rather established procedure. Yet, this technique has continued to evolve, with the aim of optimizing treatment success while reducing adverse events and risk for post-procedural reflux.
RESULTS: There is uncertainty regarding several technical aspects of the POEM myotomy; though aggregating evidence supports the use of real-time impedance planimetry to guide the myotomy. While post-POEM reflux remains a concerning long term sequela, there is an increasing focus on the potential role of endoscopic anti-reflux interventions. Lastly, with the widespread adoption of POEM, we continue to witness ongoing efforts to standardize post-procedural care and training in this procedure. POEM is no longer a novel but rather established procedure. Yet, this technique has continued to evolve, with the aim of optimizing treatment success while reducing adverse events and risk for post-procedural reflux.
摘要：
目的：POEM是社会指南认可的一种成熟方法，可作为贲门失弛缓症和痉挛性食管疾病的一线治疗方法。尽管如此，还有几个问题，包括扩大POEM的适应症，围手术期评估和管理，和最佳的POEM技术，以提高临床成功率，同时降低反流风险。
结果：关于POEM肌切开术的几个技术方面存在不确定性；尽管聚集的证据支持使用实时阻抗平面分析法来指导肌切开术。虽然POEM后的反流仍然是一个令人担忧的长期后遗症，人们越来越关注内镜抗反流干预的潜在作用.最后,随着POEM的广泛采用，我们继续目睹在这一程序中标准化程序后护理和培训的持续努力。POEM不再是一个新颖的程序，而是既定的程序。然而，这项技术不断发展，目的是优化治疗成功率，同时减少不良事件和术后反流风险。
结果：关于POEM肌切开术的几个技术方面存在不确定性；尽管聚集的证据支持使用实时阻抗平面分析法来指导肌切开术。虽然POEM后的反流仍然是一个令人担忧的长期后遗症，人们越来越关注内镜抗反流干预的潜在作用.最后,随着POEM的广泛采用，我们继续目睹在这一程序中标准化程序后护理和培训的持续努力。POEM不再是一个新颖的程序，而是既定的程序。然而，这项技术不断发展，目的是优化治疗成功率，同时减少不良事件和术后反流风险。
