Peroral endoscopic myotomy (POEM) in the treatment of severe postfundoplication dysphagia
Authors:
M. Vašátko 1; K. Hugová 1; J. Jarošová 1; J. Špičák 1; J. Martínek 1
Authors‘ workplace:
M. Vašátko, K. Hugová1, J. Jarošová1, J. Špičák1, J. Martínek1
1
Published in:
Rozhl. Chir., 2023, roč. 102, č. 5, s. 208-213.
Category:
Case Report
doi:
https://doi.org/10.33699/PIS.2023.102.5.208–213
Overview
Although uncommon, chronic postfundoplication dysphagia (PFD) is a serious complication of antireflux surgery. Currently, reoperation is the only possible solution as endoscopic pneumatic or hydraulic dilation are not effective. At present, POEM represents a standard method for the treatment of esophageal achalasia; however, in patients with PFD it is an experimental approach whose clinical effectiveness is unknown. Our case report describes a female patient who suffered from severe PFD after two surgeries (fundoplication and subsequent reoperation). Dysphagia and progressive weight loss had developed over the years and all treatment attempts (several sessions of dilation) were unsuccessful. Subsequently, esophageal resection was considered as the last resort. After a discussion in a multidisciplinary team and additional examinations (EndoFLIP), POEM was performed without any complications, and the procedure had an excellent effect without any adverse events.
Keywords:
POEM – case report – pneumatic dilation – laparoscopic fundoplication – postfundoplication dysphagia
Sources
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2023 Issue 5
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