Peroral Endoscopic Myotomy for Treating Achalasia in an Animal Model: A Feasibility Study

Title
Peroral Endoscopic Myotomy for Treating Achalasia in an Animal Model: A Feasibility Study
Authors
신용운; 권계숙; 김형길; 방병욱; 김준미; 이돈행
Keywords
Esophagus; Esophageal achalasia; Endoscopy; Animal models; Feasibility studies
Issue Date
2013
Publisher
CLINICAL ENDOSCOPY
Series/Report no.
CLINICAL ENDOSCOPY ; 제46권 제1호 pp 54~58
Abstract
Background/Aims: Laparoscopic Heller myotomy with antireflux procedure is considered to be a standard treatment for achalasia. Recently, peroral endoscopic myotomy (POEM) was developed and performed on patients with achalasia. However, there is no report on POEM use in South Korea. The aim of this study was to evaluate the technical feasibility of POEM in a porcine model. Methods: POEM was performed on two mini pigs. We performed upper endoscopy under general anesthesia. A submucosal tunnel was created and the circular muscle layer was incised using several knives. The mucosal entry was closed using resolution clips. We performed a follow-up endoscopy and sacrificed the pigs 2 weeks after the POEM. The myotomy site was evaluated grossly and histologically. Results: POEM was successfully performed on the two mini pigs. No injuries to any abdominal or mediastinal structures occurred. Two weeks after the POEM, the esophageal mucosa healed without any endoscopic evidence of complications. Necropsy revealed that the circular muscle layer was completely lost and replaced with fibrotic tissue. Conclusions: We found that POEM is a technically feasible method which can be performed on an animal model. However, to ensure safe use on patients with achalasia, further studies on technical methods and long-term follow-up examinations are required.
URI
http://dx.doi.org/10.5946/ce.2013.46.1.54
http://dspace.inha.ac.kr/handle/10505/33820
ISSN
1225-7001
Appears in Collections:
Medical School/College of Medicine (의학전문대학원/의과대학) > Medical Science (의학) > Local Access Journal Papers, Reports(의학 논문, 보고서)

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