Achalasia – POEM Method as a surgery alternative

I have achalasia since 2008. In the past I had some 5 balloon dilation. Because this was not really helping me out of my achalasia problems, I searched for another alternative. I spoke to my surgeon on February 2012 and he told me about a new method called POEM (Peroral Endoscopic myotomy).

So I started to investigate in the internet about POEM. I did find some references searching Google using POEM, but more I found using ‘Peroral Endoscopic myotomy’. Like this I found some good articles and even videos. And a lot of people as well as physicians were positively impressed by this new method.

POEM was invented by Prof. H. Inoue (JAP). So far he did POEM procedure in 205 consecutive cases in the hospital at Yokohama. Including the experience in oversea countries it reaches more than 240. Patients who received POEM in his early series are all fine with no sign of recurrence of dysphagia

Two weeks later I decided to apply the new method POEM. I hope POEM will help me in reducing the chest pain, difficulty swallowing and regurgitation during the night.

But how I got to the decision appling to me the surgery method POEM?

Well, as life goes one just get nothing for free. Well, there are a few exceptions, but that’s another topic. I wanted to know where is the catch. Otherwise POEM would be really revolutionary. The only I found negative about the method is that there are no long-term results available. The first operation was done about 3-4 years ago. What happened to this patients and how are they feeling today? I could not find to many information. But it seems that patients which undergone such a treatment had at least for 2 years a much better quality of life. I would estimate that can be extrapolated to another 2 – 4 years, so I think if an intervention using POEM runs perfectly, then you can get about 6-8 years with minor achalasia problems or even cured. These are my personal impressions. Not too bad I thought.

What is the alternative? Balloon dilatation is okay, but it has risks because of perforation, and it can not be repeated to many times. Then there is still the surgical interventions in a traditional fashion. Not controversial and although today these procedures are very well known in the implementation and minimally invasive, it is for the body a much greater trauma (multiple layers must be cut by the operators until they locate the right place of the muscle) as using the method POEM.

Well, POEM seems to me a very sensitive, highly technical supported and gentle way of doing a surgery. After all these positive comments on the internet, knowing that Prof. H. Inoue will personally perform the operation to me, I can not decide otherwise. Also I can contribute more on the long-term experience knowledge.