Peroral endoscopic myotomy for management of gastrointestinal motility disorder

Table 1 Comparison of advantages and disadvantages of different peroral endoscopic myotomies and specific indications

Modified POEM	Ref.	Special indications	Advantages	Disadvantages
Classical POEM	Ponds et al[3]	Children	-	-
		Patients after bypass
		Diffuse esophageal spasm
		Nutcracker esophagus
O-POEM	Liu et al[14]	Sigmoid-shaped esophagus	Time-saving Less technical-demanding	A little higher rate of AEs
		Failed Heller myotomy		Potential infection-related AEs
		Severe submucosal fibrosis
D-O-POEM	Yuan et al[23]	Patients with negative predictors	Time-saving	A little higher rate of AEs
			Less technical-demanding	Potential infection-related AEs
			Avoid retreatment	Risk of perforation and leakage
			Less risk of adverse insufflation events
Dual-POEM	Yuan et al[24]	Patients with negative predictors	Avoiding retreatment	More time-consuming More technical-demanding
Short tunnel POEM	Li et al[25]	-	Higher safety	More technical-demanding
			Lower rate of AEs
Liu-poem	Liu et al[26]	-	Time-saving	-
			Less technical-demanding
			Less gas-related AEs
Half tunnel POEM	Philips et al[39]	-	Time-saving	-
			Less technical-demanding
Thin-POEM	Hernandez Mondragón et al[40]	-	Time-saving	Operational limitations
			Higher safety
TIF POEM	Gutierrez et al[41]	Pre- and post-POEM GERD	Treatment of GERD	Higher technical-demanding
Topography module POEM	Wellington et al[44]	-	Optimal length of myotomy	-
D-POEM	Yang et al[27]	Esophageal diverticula	-	-
G-POEM	Khashab et al[33]	Post-LSG gastric stenosis after a failed pneumatic dilation	-	-
		Refractory gastroparesis

POEM: Peroral endoscopic myotomy; O-POEM: Open peroral endoscopic myotomy; AEs: Adverse events; D-O-POEM: Double open peroral endoscopic myotomy; TIF: Transoral incisionless fundoplication; GERD: Gastroesophageal reflux disease; D-POEM: Diverticulum peroral endoscopic myotomy; G-POEM: Gastroparesis peroral endoscopic myotomy; LSG: Laparoscopic sleeve gastrectomy.