胃腸および消化器系

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Intraoperative Functional Luminal Imaging to Assess Esophagogastric Junction Distensibility during Per-Oral Endoscopic Myotomy in Pediatric Patients

Robert Wright, Stephanie Chao, James Wall

Per-oral Endoscopic Myotomy (POEM) is a transmural endoscopic surgical technique that is gaining widespread adoption in the management of adult achalasia. The endoscopic approach offers excellent access to the muscular wall of the esophagus enabling division of the abnormal circular fibers. The procedure offers the benefits of being incisionless, preserving the outer longitudinal esophageal muscle fibers and avoiding a hiatal dissection. Endoscopic functional luminal imaging probes enable real-time measurement of luminal diameter and pressure. These probes offer intraoperative guidance to the extent and completeness of the POEM procedure. Post-operative measurements have been correlated to outcomes of dysphagia and reflux in the adult population. No functional luminal imaging exists for the pediatric population. 2 POEM procedures were performed at our children’s hospital using luminal imaging.