Efectividad de la miotomía endoscópica peroral en el tratamiento de la acalasia

Abstract

Introduction: Achalasia is a rare esophageal disorder with severe consequences. Its increasing incidence and prevalence highlight the need to understand its treatment better. Peroral Endoscopic Myotomy (POEM) offers a minimally invasive and effective therapeutic alternative. Objective: To evaluate the efficacy and safety of POEM in treating achalasia, considering its contribution to managing this disease. Methodology: Adopting the PRISMA protocol, specific databases were searched using MeSH/DeCS terms. Studies published from 2015 to 2023 examining the effectiveness and safety of POEM in patients with achalasia were included. Strict eligibility criteria were applied, and a rigorous screening and data collection process was performed. Results: Initially, 168 relevant studies were identified, of which 12 met the inclusion criteria. These studies revealed significant symptom improvement in patients treated with POEM, demonstrated by a decrease in postoperative Eckardt scores. Furthermore, it demonstrated comparable or superior efficacy to other treatment modalities, such as laparoscopic Heller myotomy. Regarding safety, it showed a low incidence of intraoperative and postoperative complications, which were mild and manageable. Conclusions: POEM is a promising option for achalasia, providing significant symptomatic improvements with an acceptable safety profile. Its efficacy comparable to standard surgical options suggests its utility as an initial treatment or alternative in selected patients. Further research is needed to evaluate its durability and long-term effectiveness compared to other therapeutic options.