ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2014
Analysis of a learning curve and predictors of intraoperative difficulty for peroral esophageal myotomy (POEM).
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Updated Systematic Review of Achalasia, with a Focus on POEM Therapy.Digestive diseases and sciences · 2020Pooled it
- Safety and efficacy of POEM for treatment of achalasia: a systematic review of the literature.Surgical endoscopy · 2017Pooled it
- A prediction model and nomogram for technical difficulty of peroral endoscopic myotomy.Surgical endoscopy · 2023Trial
- Symptomatic and physiologic outcomes one year after peroral esophageal myotomy (POEM) for treatment of achalasia.Surgical endoscopy · 2014Trial
- Saudi Gastroenterology Association (SGA) clinical care pathway and standards of care for peroral endoscopic myotomy (POEM) in achalasia.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026Article
- Peroral endoscopic myotomy for complex achalasia and the POEM difficulty score: An update.DEN open · 2025Article
- Efficacy and Safety of Peroral Endoscopic Myotomy (POEM) in Achalasia: An Updated Meta-analysis.Middle East journal of digestive diseases · 2023Article
- When is POEM truly equivalent to LHM? A comparison of complication rates during the learning curve.Surgical endoscopy · 2023Article
- Adverse Events Associated With Peroral Endoscopic Myotomy Affecting Extended Hospital Stay: A Multi-center Retrospective Study in South Korea.Journal of neurogastroenterology and motility · 2022Article
- Optimization of insufflation and pressure control in third-space endoscopy.Surgical endoscopy · 2022Article
- Pilot prospective study on formal training in per-oral endoscopic myotomy (POEM) during advanced endoscopy fellowship.Endoscopy international open · 2021Article
- The Learning Curve for Peroral Endoscopic Myotomy in Latin America: A Slide to the Right?Clinical endoscopy · 2021Article
- Peroral endoscopic myotomy: techniques and outcomes.Shanghai chest · 2021Article
- Long-term outcomes of per-oral endoscopic myotomy compared to laparoscopic Heller myotomy for achalasia: a single-center experience.Surgical endoscopy · 2021Article
- Per-oral endoscopic myotomy (POEM) training and skills evaluation tool: a pilot study.Endoscopy international open · 2020Article
- The status of training in new technologies in advanced endoscopy: from defining competence to credentialing and privileging.Gastrointestinal endoscopy · 2020Review
- Outcomes and quality of life assessment after per oral endoscopic myotomy (POEM) performed in the endoscopy unit with trainees.Surgical endoscopy · 2018Article
- Per oral endoscopic myotomy: early experience and safety of a multispecialty approach.Surgical endoscopy · 2018Article
- Treatment of Idiopathic Achalasia with Per-Oral Esophageal Myotomy.Techniques in gastrointestinal endoscopy · 2018Article
- Per-oral endoscopic myotomy (POEM): mid-term efficacy and safety.Surgical endoscopy · 2018Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeroral esophageal myotomy (POEM) is an endoscopic surgical operation for achalasia. Here, we analyze a single-series POEM learning curve and examine which preoperative patient factors are predictive of operative difficulty.
methodsTwo surgeons performed all POEM procedures conjointly. Nonlinear regression was used to determine the learning curve for procedure time. Preoperative patient characteristics were correlated with outcomes.
resultsThirty-six POEM procedures were performed. Total operative time did not decrease over the course of the series (mean 112 ± 36 min). Time required to complete the procedural steps of submucosal access and myotomy did decrease with experience, both exhibiting a "learning rate" of seven cases. The incidence of inadvertent mucosal perforations and the number of clips required both decreased with experience. Postoperative Eckardt scores at 1-year follow-up decreased over the course of the series. Prior endoscopic treatment, symptom duration, and esophageal width were all independently predictive of longer procedure time. Preoperative symptom duration was also positively associated with inadvertent mucosal perforation and the number of clips required.
conclusionsIn this series, overall procedure time did not decrease with experience and may not be an important marker of procedural skill for POEM. Prior endoscopic treatment, longer symptom duration, and esophageal dilatation may result in increased operative difficulty during POEM.
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