A prospective randomized multicentre study comparing endoscopic pneumatic balloon dilation and per oral endoscopic myotomy (POEM) as treatment of idiopathic achalasia

1st January 2017 - ongoing

Status: In Recruitment

Specialism: Imaging, Advanced Endoscopic Imaging, Upper GI.


Achalasia is a rare oesophageal motility disorder that results in distressing symptoms of dysphagia, chest pains, vomiting, regurgitation, aspiration pneumonia, weight loss and rarely can lead on to oesophageal cancer. Key element of the treatment is to disrupt the spastic lower oesophageal sphincter via a dilatation or myotomy. Current definitive treatment option includes endoscopic pneumatic balloon dilation or laparoscopic Heller’s myotomy. Both of these interventions are not perfect since although endoscopy is minimally invasive the response is not sustained and carries a risk of perforation ~5% and Lap. Heller’s requires a surgical procedure. A novel intervention is the Per-oral Endoscopic Myotomy (POEM). This combines the advantage of being an endoscopic procedure and allows a controlled myotomy without a surgical intervention or uncontrolled disruption of LOS by balloon dilation. This study conducted in multiple centres in Europe will provide evidence to advice if POEM can be included in the treatment options for Achalasia.

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