Asian Institute of Gastroenterology, Hyderabad, India
Copyright © 2023 Korean Society of Gastrointestinal Endoscopy
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
The authors have no potential conflicts of interest.
Funding
None.
Author Contributions
Conceptualization: ZN; Data curation: ZN, DNR; Formal analysis: ZN; Supervision: DNR; Validation: DNR; Visualisation: ZN, DNR; Writing–original draft: ZN; Writing–review & editing: DNR.
Study | Country, study design | n | Age (yr) | Type of motility disorder | Reflux esophagitis (%) | Clinical success (%) | Follow-up (mo) |
---|---|---|---|---|---|---|---|
Guo et al. (2017)14 | China, R | 67 | 40.7±15.3 | I 13, II 50, III 4 | 13.4 | 88.1 | 40.1±2.8 |
Hernández Mondragón et al. (2017)15 | Mexico, R | 65 | 47 (20–81) | I 19, II 34, III 12 | 15.4 | 72 | 48 |
Teitelbaum et al. (2018)16 | USA, R | 36 | 54.5 (20–88) | I 10, II 17, | 13 | 79.3 | 65 (60–76) |
DES 2, EGJOO 7 | |||||||
Liu et al. (2020)17 | China, R | 1,538 | 40.3±14.5 | I 466, II 964, III 108 | 22.6 | 92.9 | 42 |
Brewer Gutierrez et al. (2020)18 | Multicenter, R | 146 | 49.8±16 | I 41, II 70, III 9 | 16.8 | 95.2 | 55 (49.9–60.6) |
Podboy et al. (2021)21 | USA, R | 55 | 59.18±2.4 | I 13, II 23, III 15, | 3.6 | 72.7 | 47.3±13.8 |
US 2, EGJOO 1, DES 1 | |||||||
Nabi et al. (2021)23 | India, R | 74 | 43.5±16.09 | III 53, DES 11, JHE 10 | 48.6 | 90.5 | 47.5 (2–77) |
Onimaru et al. (2021)24 | Japan, R | 15 | 49.7±15.9 | NR | NR | 73.3 | ≥120 |
McKay et al. (2021)25 | USA, P | 100 | 57 (20–88) | I 29, II 41, III 5, | NR | 79 | 72 (66–82) |
EGJOO19, DES 6 | |||||||
Campagna et al. (2021)27 | USA, R | 100 | 53 | I 27, II 58, III 16 | 33.3 | 88 | 55 |
EGJOO 8, JHE 4, DES 1 |
Study | n | Size (mm) | Procedure time (min) | Adverse events (%) | Clinical success (%) | Follow-up (mo) |
---|---|---|---|---|---|---|
Repici et al. (2020)42 | 20 | 17.5 | 13.8 | 0 | 100 | 12 |
Yang et al. (2020)43 | 75 | 31.3 | 52.4 | 6.7 | 92.0 | 9.7 |
Budnicka et al. (2021)44 | 22 | 30 | 48.8 | 13.6 | 90.9 | 3 |
Elkholy et al. (2021)45 | 24 | 40 | 61 | 0 | 95.8 | 10 |
Sanaei et al. (2021)46 | 32 | 29.4 | 47.7 | 12.5 | 96.7 | 5.5 |
Mittal et al. (2021)47 | 24 | 27 | NR | 16.7 | 90.9 | 5.7 |
Al Ghamdi et al. (2022)48 | 119 | 34.8 | 46.1 | 16.8 | 92.7 | NR |
Kahaleh et al. (2022)49 | 52 | NR | 42.5 | 9.6 | 92.0 | 3.4 |
Study | Study design | n | Age (yr) | Etiology (%) | Clinical success (%) | Adverse events (%) | Predictors of success or failure |
---|---|---|---|---|---|---|---|
Mekaroonkamol et al. (2019)64 | Retrospective, single center | 40 | 47.7±15.5 | DG: 62.5 | 80.0 at 1 mo | 7.5 | Success: predominant nausea/vomiting and shorter duration of disease |
NDG: 37.5 | 57.1 at 1 yr | ||||||
70.0 at 1.5 yr | |||||||
Gregor et al. (2021)65 | Prospective, single center | 52 | 48 (25–80) | DG: 40.5 | 58.0 at 6 mo | 5.8 | Failure: longer duration of symptoms |
NDG: 59.5 | 48.0 at 1 yr | ||||||
Abdelfatah et al. (2021)66 | Retrospective, single center | 90 | 42.4±12.6 | DG: 42.2 | 81.0 at 3–6 mo | 4.4 | Failure: high BMI and use of psychiatric medications |
NDG: 57.8 | 69.1 at 1 yr | ||||||
Ragi et al. (2021)67 | Retrospective, multicenter | 76 | 56 (43–64) | DG: 34.2 | 65.8 at 1 yr | 6 | Success: high preoperative GCSI satiety subscale score |
NDG: 65.8 | Failure: high rate of gastric retention at 4 hours | ||||||
Vosoughi et al. (2022)68 | Prospective, multicenter | 80 | 49.3±14.9 | DG: 23.8 | 57.5 at 1 mo | 6.2 | Success: baseline GCSI Score >2.6 and baseline gastric retention >20% at 4 hours |
NDG: 76.2 | 56.0 at 1 yr | ||||||
Labonde et al. (2022)69 | Prospective, multicenter | 46 | 54±15.9 | DG: 32.6 | 65.2 at 3 yr | NR | Success: cases with predictive score ≥2 |
NDG: 67.4 |
POEM, per-oral endoscopic myotomy; PD, pneumatic dilatation; HM, Heller’s myotomy; GERD, gastroesophageal reflux disease; STER, submucosal tunneling endoscopic resection; POET, per-oral endoscopic tumor resection; G-POEM, gastric POEM; EndoFLIP, endoluminal functional lumen imaging probe; PREM, per-rectal endoscopic myotomy; POETRE, per-oral endoscopic tunneling for restoration of the esophagus.
Study | Country, study design | n | Age (yr) | Type of motility disorder | Reflux esophagitis (%) | Clinical success (%) | Follow-up (mo) |
---|---|---|---|---|---|---|---|
Guo et al. (2017)14 | China, R | 67 | 40.7±15.3 | I 13, II 50, III 4 | 13.4 | 88.1 | 40.1±2.8 |
Hernández Mondragón et al. (2017)15 | Mexico, R | 65 | 47 (20–81) | I 19, II 34, III 12 | 15.4 | 72 | 48 |
Teitelbaum et al. (2018)16 | USA, R | 36 | 54.5 (20–88) | I 10, II 17, | 13 | 79.3 | 65 (60–76) |
DES 2, EGJOO 7 | |||||||
Liu et al. (2020)17 | China, R | 1,538 | 40.3±14.5 | I 466, II 964, III 108 | 22.6 | 92.9 | 42 |
Brewer Gutierrez et al. (2020)18 | Multicenter, R | 146 | 49.8±16 | I 41, II 70, III 9 | 16.8 | 95.2 | 55 (49.9–60.6) |
Podboy et al. (2021)21 | USA, R | 55 | 59.18±2.4 | I 13, II 23, III 15, | 3.6 | 72.7 | 47.3±13.8 |
US 2, EGJOO 1, DES 1 | |||||||
Nabi et al. (2021)23 | India, R | 74 | 43.5±16.09 | III 53, DES 11, JHE 10 | 48.6 | 90.5 | 47.5 (2–77) |
Onimaru et al. (2021)24 | Japan, R | 15 | 49.7±15.9 | NR | NR | 73.3 | ≥120 |
McKay et al. (2021)25 | USA, P | 100 | 57 (20–88) | I 29, II 41, III 5, | NR | 79 | 72 (66–82) |
EGJOO19, DES 6 | |||||||
Campagna et al. (2021)27 | USA, R | 100 | 53 | I 27, II 58, III 16 | 33.3 | 88 | 55 |
EGJOO 8, JHE 4, DES 1 |
Study | n | Size (mm) | Procedure time (min) | Adverse events (%) | Clinical success (%) | Follow-up (mo) |
---|---|---|---|---|---|---|
Repici et al. (2020)42 | 20 | 17.5 | 13.8 | 0 | 100 | 12 |
Yang et al. (2020)43 | 75 | 31.3 | 52.4 | 6.7 | 92.0 | 9.7 |
Budnicka et al. (2021)44 | 22 | 30 | 48.8 | 13.6 | 90.9 | 3 |
Elkholy et al. (2021)45 | 24 | 40 | 61 | 0 | 95.8 | 10 |
Sanaei et al. (2021)46 | 32 | 29.4 | 47.7 | 12.5 | 96.7 | 5.5 |
Mittal et al. (2021)47 | 24 | 27 | NR | 16.7 | 90.9 | 5.7 |
Al Ghamdi et al. (2022)48 | 119 | 34.8 | 46.1 | 16.8 | 92.7 | NR |
Kahaleh et al. (2022)49 | 52 | NR | 42.5 | 9.6 | 92.0 | 3.4 |
Study | Study design | n | Age (yr) | Etiology (%) | Clinical success (%) | Adverse events (%) | Predictors of success or failure |
---|---|---|---|---|---|---|---|
Mekaroonkamol et al. (2019)64 | Retrospective, single center | 40 | 47.7±15.5 | DG: 62.5 | 80.0 at 1 mo | 7.5 | Success: predominant nausea/vomiting and shorter duration of disease |
NDG: 37.5 | 57.1 at 1 yr | ||||||
70.0 at 1.5 yr | |||||||
Gregor et al. (2021)65 | Prospective, single center | 52 | 48 (25–80) | DG: 40.5 | 58.0 at 6 mo | 5.8 | Failure: longer duration of symptoms |
NDG: 59.5 | 48.0 at 1 yr | ||||||
Abdelfatah et al. (2021)66 | Retrospective, single center | 90 | 42.4±12.6 | DG: 42.2 | 81.0 at 3–6 mo | 4.4 | Failure: high BMI and use of psychiatric medications |
NDG: 57.8 | 69.1 at 1 yr | ||||||
Ragi et al. (2021)67 | Retrospective, multicenter | 76 | 56 (43–64) | DG: 34.2 | 65.8 at 1 yr | 6 | Success: high preoperative GCSI satiety subscale score |
NDG: 65.8 | Failure: high rate of gastric retention at 4 hours | ||||||
Vosoughi et al. (2022)68 | Prospective, multicenter | 80 | 49.3±14.9 | DG: 23.8 | 57.5 at 1 mo | 6.2 | Success: baseline GCSI Score >2.6 and baseline gastric retention >20% at 4 hours |
NDG: 76.2 | 56.0 at 1 yr | ||||||
Labonde et al. (2022)69 | Prospective, multicenter | 46 | 54±15.9 | DG: 32.6 | 65.2 at 3 yr | NR | Success: cases with predictive score ≥2 |
NDG: 67.4 |
Disease | Procedure | Update | Future directions |
---|---|---|---|
Achalasia cardia | POEM | Short and long esophageal myotomy are equally effective in type I/II achalasia | Long-term outcomes of POEM especially with reference to gastroesophageal reflux; modified techniques for prevention of GERD |
Single dose of antibiotic prophylaxis may be sufficient before POEM | |||
POEM is superior to PD and equivalent to HM at 2-years follow-up | |||
Subepithelial tumors | STER/POET | Transesophageal resection of mediastinal cysts and extraluminal tumors is feasible | Randomized comparison with endoscopic submucosal excavation, predictors of en-bloc resection |
Gastroparesis | G-POEM | Outcomes of G-POEM are modest in refractory gastroparesis | Long-term outcomes, utility of EndoFLIP and predictors of outcomes, randomized comparison with surgical pyloroplasty |
Zenker’s diverticulum | Z-POEM | Variation in techniques (over the septum, Z-POEM+mucosotmy and hybrid Z-POEM) may improve technical and clinical outcomes | Long-term outcomes of Z-POEM and comparative trials with flexible endoscopic myotomy |
Others (Hirschsprung’s disease, esophageal strictures) | PREM, POETRE | Submucosal endoscopy may be a potential alternative to surgery in Hirschsprung’s disease and complete esophageal obstruction | Long-term outcomes, comparison with surgery |
Values are presented as mean±standard deviation or median (range). R, retrospective; DES, diffuse esophageal spasm; EGJOO, esophagogastric junction outflow obstruction; NR, not reported; JHE, jackhammer esophagus; P, prospective; US, unspecified.
NR, not reported.
Values are presented as mean±standard deviation or median (range). DG, diabetic gastroparesis; NDG, non-diabetic gastroparesis; BMI, body mass index; GCSI, gastric cardinal symptom index; NR, not reported.
POEM, per-oral endoscopic myotomy; PD, pneumatic dilatation; HM, Heller’s myotomy; GERD, gastroesophageal reflux disease; STER, submucosal tunneling endoscopic resection; POET, per-oral endoscopic tumor resection; G-POEM, gastric POEM; EndoFLIP, endoluminal functional lumen imaging probe; PREM, per-rectal endoscopic myotomy; POETRE, per-oral endoscopic tunneling for restoration of the esophagus.