Recurrent symptoms after per-oral endoscopic myotomy in achalasia: Redo, dilate, or operate? A call for a tailored approach

We read with interest the study by Van Hoeij et al1 in this issue of Gastrointestinal Endoscopy on the management of recurrent dysphagia symptom in patients who underwent prior per-oral endoscopic myotomy (POEM) in the treatment of achalasia. Since the first published case series by Inoue et al2 in 2010 showing the safety and efficacy of the use of a submucosal tunnel to perform esophageal myotomy, POEM has gained increasing popularity as a first-line therapy for treatment of achalasia. Although response rates of >90% have widely been reported,3-5 there is a subset of patients who fail POEM and develop recurrent symptoms.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jxYWaw