Guest guest Posted January 30, 2012 Report Share Posted January 30, 2012 Hello all. I have been reading this group for some time and was surprised to see a discussion about POEM surgery as I have an appt tomorrow to discuss this option. Here's my history: I am a 52 yo male from New York and I was diagnosed with achalasia in 1990. Between 1990 and 1997 I had more dilations than I care to count. I finally agreed to surgery in 1997 since it would be done laparoscopically. I had a Heller's myotomy with a partial fundo and had relief for about 4 yrs. Unfortunately the symptoms returned over time and I had 2 or 3 dilations and for the past several years I go to the hospital every 4-5 mos for Botox injections. My GI has been having difficulty doing the endoscopy since there is so much food in my esophagus. It got so bad that about 9 months ago he hospitalized me so that my esophagus and stomach could be pumped and he could get a clear view of exactly where the injections should be given. My last Botox was this past Friday and as each nurse walked into the operating room they greeted me by first name. I told them as much as I enjoy talking with them, a hospital in NOT a place where I'm glad everyone knows my name!! Lol. I have an appt tomorrow at Winthrop hospital to discuss whether or not the new POEM procedure will do me any good. POEM generally isn't an option for someone who had a previous myotomy, however there have been limited cases where this has been done. Although I'm not expecting much, I am hopeful. I'm willing to try just about anything in the name of relief!!!! On Jan 30, 2012, at 11:25 AM, Mueller IV <mt4mar@...> wrote: > I have spoke with a few surgeons about this method and they have leaned on the side of it not having a high success rate. Our disease is not well researched to begin with in the whole scope of things. I am glad you have added this information. I feel it is important to have as much information available so we can make better decisions about what course an individual will make. > > Sent from my iPhone > > On Jan 30, 2012, at 10:58, " dd.haas " <dd.haas@...> wrote: > > > Hi , > > I´m new here. Had HM with Toupet 2009 and feel fine. > > Why I answer is, that it isn't true with this 10%. > > All in the World there are more than 400 patient operated with POEM and the success rate is as with HM about 90% with a refluxrate of 10% (like with Heller, but they do no wrap!). The largest study was done in Japan with 100 + cases and a smaller study in Germany with 30 cases. But there are other center, which do POEM one in California (I think University of C.) one in Montral, Honkong.... > > It is clear that this is a fairly young methode (just somewhat more than 2 years and that means no real lonterm study!) > > Notan gave a link to an article on from a surgical magazine from August 2011 and commented as well. Cann´t find it at the moment. > > Excuse my english. > > a > > > > > > > > > > > > > POEM is an endoscopic Heller Myotomy (so to speak). No cuts through the abdomen. All access is down through the gullet. > > > > > > > > > > More information (including a video of one being performed): > > > > > > > > > > http://daveproject.org/endoscopic-myotomy-for-the-treatment-of-achalasia/2010-05\ -03/ > > > > > > > > > > http://www.facs.org/surgerynews/update/poem1110.html > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2012 Report Share Posted January 30, 2012 Hello, Ron. Ron wrote: > > I have an appt tomorrow at Winthrop hospital to discuss whether or not > the new POEM procedure will do me any good. POEM generally isn't an > option for someone who had a previous myotomy, however there have been > limited cases where this has been done. > I avoid telling people what to do and I avoid getting between them and their doctors. But, I don't have a problem telling people what I would consider doing and why. In a case like this I would want to know if the surgeon or hospital is studying POEM, either in a formal study or just to get experience. If they are they may have an incentive to move patients into the study. That may or may not be to your benefit. With newer procedures like this it may be good to get a second opinion where they don't have reason to be biased. Of course that only applies if they decide POEM is an option for you. Ask yourself if you would want to be one of the first patients a doctor did a myotomy on. I wouldn't. Most of us here tell people they should consider getting the most experienced surgeon in doing myotomies that they can find. In this case you could be one of the first in having a relatively new procedure by a surgeon without a lot of experience doing it, even if he has done lots of other myotomies. This is not a situation that would make me comfortable. POEM may be great, the surgeon may be great and your results could possible be great. Who knows. I don't think there is enough published about it to know how good it will turn out to be in the long-term. Even in the short-term there isn't much data and not from many sources. So, who could know. notan Quote Link to comment Share on other sites More sharing options...
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