Histological findings of divided muscle after peroral endoscopic myotomy

Hironari Shiwaku; Haruhiro Inoue; Satoshi Nimura; Kanefumi Yamashita; Toshihiro Ohmiya; Shinsuke Takeno; Takamitsu Sasaki; Yuichi Yamashita

Authors Hironari Shiwaku, Haruhiro Inoue, Satoshi Nimura, Kanefumi Yamashita, Toshihiro Ohmiya, Shinsuke Takeno, Takamitsu Sasaki, Yuichi Yamashita.

Abstract

Peroral endoscopic myotomy (POEM) is a revolutionary therapy for achalasia and related disorders. POEM utilizes almost the same myotomy procedure as the Heller myotomy; thus, it would be expected to have the same or greater duration of therapeutic effect. However, to date, there have been no reports to prove the basis for this procedure in achalasia. In this case, we were able to histologically show the divided muscle after POEM since the patient had an esophagectomy for esophageal cancer. Histology showed that the muscle tissue divided by the POEM procedure was completely replaced by fibrosis. These findings may indirectly show the permanence of the POEM procedure.

Keywords Fibrosis, achalasia, peroral endoscopic myotomy

Ann Gastroenterol 2016; 29 (1): 94-95