establishment of POEM for esophageal motility disorders

• Project/Area Number: 16K09291
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Gastroenterology
• Research Institution: Showa University
• Principal Investigator: Haruhiro Inoue 昭和大学, 医学部, 教授 (90280966)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2018: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000); Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2016: ¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000)
• Keywords: アカラシア / POEM（経口内視鏡的筋層切開術） / びまん性食道攣縮 / Nutcracker食道 / 食道運動機能障害 / 先天性食道狭窄 / Jack-Hammer食道 / 上部消化管学（食道・胃・十二指腸）

Outline of Final Research Achievements

Standard treatment for esophageal achalasia was used to be laparoscopic surgery. We developed a novel minimally invasive endoscopic treatment for esophageal achalasia in 2008. It is namely POEM (Per-oral endoscopic myotomy). Success rate of POEM exceeds 97% and treatment guideline was also published (Inoue H et al. Dig Endosc 2018; 30: 563-79). Data of more than 3000 POEM cases which were collected whole Japan was also published to GIE. POEM has been accepted worldwide and now it becomes a standard first-line treatment for esophageal achalasia.

Academic Significance and Societal Importance of the Research Achievements

食道アカラシアに対するPOEM手術（経口内視鏡的筋層切開術）は、2008年にわれわれが世界に先駆けて発表した。それ以来、当院だけでも2100例以上、全国でも3000例以上の患者さんにPOEM手術が施行された。保険収載もされ、また治療ガイドラインも発表されている。現在は、国際的にも食道アカラシアに対する標準術式となってきた。これまで外科手術しかなかったアカラシアに対する根治療法を、低侵襲の内視鏡治療としておこなえるようになったことは、患者への朗報であると思われる。

Research Products

• [Journal Article] Multicenter collaborative retrospective evaluation of peroral endoscopic myotomy for esophageal achalasia: analysis of data from more than 1300 patients at eight facilities in Japan (2020)
  • Author(s): Shiwaku H, Inoue H, Onimaru M, Minami H, Sato H, Sato C, Tanaka S, Ogawa R, Okushima N
  • Journal Title: Surgical Endoscopy Volume: 34 Pages: 464-468
  • Peer Reviewed
• [Journal Article] Clinical outcomes of per‐oral endoscopic tumor resection for submucosal tumors in the esophagus and gastric cardia (2020)
  • Author(s): Onimaru Manabu、Inoue Haruhiro、Bechara Robert、Tanabe Mayo、Abad Mary Raina Angeli、Ueno Akiko、Shimamura Yuto、Sumi Kazuya、Ikeda Haruo、Ito Hiroaki
  • Journal Title: Digestive Endoscopy Volume: 32 Issue: 3 Pages: 328-336
  • DOI: 10.1111/den.13471
  • Peer Reviewed
• [Journal Article] Gastroesophageal reflux disease after peroral endoscopic myotomy: lest we forget what we already know (2020)
  • Author(s): Bechara Robert、Inoue Haruhiro、Shimamura Yuto、Reed David
  • Journal Title: Diseases of the Esophagus Volume: 32 Issue: 12 Pages: 1-7
  • DOI: 10.1093/dote/doz106
  • Peer Reviewed
• [Journal Article] Peroral endoscopic myotomy for achalasia: a prospective multicenter study in Japan (2020)
  • Author(s): Shiwaku Hironari、Inoue Haruhiro、Sato Hiroki、Onimaru Manabu、Minami Hitomi、Tanaka Shinwa、Sato Chiaki、Ogawa Ryo、Okushima Norihiko、Yokomichi Hiroshi
  • Journal Title: Gastrointestinal Endoscopy Volume: 91 Issue: 5 Pages: 1037-1044
  • DOI: 10.1016/j.gie.2019.11.020
  • Peer Reviewed / Open Access
• [Journal Article] POEM as salvage therapy in patients with achalasia refractory to endoscopic or surgical therapy is technically feasible and safe: A systematic review and meta‐analysis (2020)
  • Author(s): Hashimoto Rintaro、Inoue Haruhiro、Shimamura Yuto、Sakuraba Atsushi、Tomizawa Yutaka
  • Journal Title: Digestive Endoscopy Volume: - Issue: 7 Pages: 1042-1049
  • DOI: 10.1111/den.13643
  • Peer Reviewed
• [Journal Article] Statement for gastroesophageal reflux disease after peroral endoscopic myotomy from an international multicenter experience. (2020)
  • Author(s): Inoue H, Shiwaku H, Kobayashi Y, Chiu PWY, Hawes RH, Neuhaus H, Costamagna G, Stavropoulos SN, Fukami N, Seewald S, Onimaru M, Minami H, Tanaka S, Shimamura Y, Santi EG, Grimes K, Tajiri H.
  • Journal Title: Esophagus Volume: 17 Issue: 1 Pages: 3-10
  • DOI: 10.1007/s10388-019-00689-6
  • NAID: 40022141180
  • Peer Reviewed / Open Access
• [Journal Article] Peroral endoscopic myotomy and fundoplication: a novel NOTES procedure (2019)
  • Author(s): Inoue Haruhiro、Ueno Akiko、Shimamura Yuto、Manolakis Anastassios、Sharma Ashish、Kono Shin、Nishimoto Masayuki、Sumi Kazuya、Ikeda Haruo、Goda Kenichi、Onimaru Manabu、Yamaguchi Noriko、Itoh Hiroaki
  • Journal Title: Endoscopy Volume: 51 Issue: 02 Pages: 161-164
  • DOI: 10.1055/a-0820-2731
  • Peer Reviewed
• [Journal Article] Anterior versus posterior myotomy during POEM for the treatment of achalasia: systematic review and meta-analysis of randomized clinical trials (2019)
  • Author(s): Rodríguez de Santiago E, Mohammed N, Manolakis A, Shimamura Y, Onimaru M, Inoue H
  • Journal Title: Journal of Gastrointestinal and Liver Diseases Volume: 28 Issue: 1 Pages: 107-115
  • DOI: 10.15403/jgld.2014.1121.281.pom
  • Peer Reviewed
• [Journal Article] 2007-2019: a "Third"-Space Odyssey in the Endoscopic Management of Gastrointestinal Tract Diseases (2019)
  • Author(s): Manolakis AC, Inoue H, Ueno A, Shimamura Y
  • Journal Title: Curr Treat Options Gastroentero Volume: 17 Pages: 202-220
  • Peer Reviewed
• [Journal Article] Multicenter Evaluation of Clinical Efficacy and Safety of Per-oral Endoscopic Myotomy in Children (2019)
  • Author(s): Choné A, Familiari P, von Rahden B, Desai P, Inoue H, Shimamura Y, Eleftheriadis N, Yamashita K, Khashab MA, Shiwaku H, Seewald S, e.t.c
  • Journal Title: Journal of Pediatric Gastroenterology and Nutrition Volume: 69 Issue: 5 Pages: 523-527
  • DOI: 10.1097/mpg.0000000000002432
  • Peer Reviewed
• [Journal Article] Identification of human herpes virus 1 encoded micro RNAs in biopsy samples of lower esophageal sphincter muscle during per-oral endoscopic myotomy for esophageal achalasia (2019)
  • Author(s): Ikebuchi Yuichiro、Kanda Tsutomu、Ikeda Haruo、Yoshida Akira、Sakaguchi Takuki、Urabe Shigetoshi、Minami Hitomi、Nakao Kazuhiko、Kuwamoto Satoshi、Inoue Haruhiro、Isomoto Hajime
  • Journal Title: Digestive Endoscopy Volume: 32 Issue: 1 Pages: 136-142
  • DOI: 10.1111/den.13491
  • Peer Reviewed
• [Journal Article] Gastric myotomy length affects severity but not rate of post-procedure reflux: 3-year follow-up of a prospective randomized controlled trial of double-scope per-oral endoscopic myotomy (POEM) for esophageal achalasia (2019)
  • Author(s): Grimes KL, Bechara R, Shimamura Y, Ikeda H, Inoue H
  • Journal Title: Surgical Endoscopy Volume: -
  • Peer Reviewed
• [Journal Article] Peroral endoscopic myotomy (POEM) opens the door of third-space endoscopy (2019)
  • Author(s): Inoue Haruhiro、Maydeo Amit
  • Journal Title: Endoscopy Volume: 51 Issue: 11 Pages: 1010-1012
  • DOI: 10.1055/a-1019-1865
  • Peer Reviewed
• [Journal Article] Peroral endoscopic myotomy (POEM) for complex achalasia and the POEM difficulty score (2019)
  • Author(s): Bechara Robert、Woo Matthew、Hookey Lawrence、Chung Wiley、Grimes Kevin、Ikeda Haruo、Onimaru Manabu、Sumi Kazuya、Nakamura Jun、Hata Yoshitaka、Maruyama Shota、Gomi Kuniyo、Shimamura Yuto、Inoue Haruhiro
  • Journal Title: Digestive Endoscopy Volume: 31 Issue: 2 Pages: 148-155
  • DOI: 10.1111/den.13294
• [Journal Article] New endoscopic finding of esophageal achalasia with ST Hood short type: Corona appearance (2018)
  • Author(s): Shiwaku Hironari、Yamashita Kanefumi、Ohmiya Toshihiro、Nimura Satoshi、Shiwaku Yoshiyuki、Inoue Haruhiro、Hasegawa Suguru
  • Journal Title: PLOS ONE Volume: 13 Issue: 7 Pages: e0199955-e0199955
  • DOI: 10.1371/journal.pone.0199955
• [Journal Article] Clinical practice guidelines for peroral endoscopic myotomy (2018)
  • Author(s): Inoue Haruhiro、Shiwaku Hironari、Iwakiri Katsuhiko、Onimaru Manabu、Kobayashi Yasutoshi、Minami Hitomi、Sato Hiroki、Kitano Seigo、Iwakiri Ryuichi、Omura Nobuo、Murakami Kazunari、Fukami Norio、Fujimoto Kazuma、Tajiri Hisao
  • Journal Title: Digestive Endoscopy Volume: 30 Issue: 5 Pages: 563-579
  • DOI: 10.1111/den.13239
• [Journal Article] Retraction notice to “Long-term outcomes of per-oral endoscopic myotomy in patients with achalasia with a minimum follow-up of 2 years: an international multicenter study” (2018)
  • Author(s): Ngamruengphong 、Inoue Haruhiro、e.t.c
  • Journal Title: Gastrointestinal Endoscopy Volume: 87 Issue: 4 Pages: 1164-1164
  • DOI: 10.1016/j.gie.2018.02.005
• [Journal Article] Dynamic lumen obstructing angulation in advanced sigmoid-type achalasia successfully treated by additional proximal curve myotomy (2018)
  • Author(s): Seewald Stefan、Ang Tiing、Patak Michael、Yu Kim Teng Karl、Inoue Haruhiro
  • Journal Title: Endoscopy Volume: 50 Issue: 05 Pages: E117-E118
  • DOI: 10.1055/s-0044-101017
• [Journal Article] Per-oral endoscopic myotomy for esophageal achalasia in a case of Allgrove syndrome (2018)
  • Author(s): Nakamura Jun、Hikichi Takuto、Inoue Haruhiro、Watanabe Ko、Kikuchi Hitomi、Takagi Tadayuki、Suzuki Rei、Sugimoto Mitsuru、Konno Naoki、Waragai Yuichi、Asama Hiroyuki、Takasumi Mika、Sato Yuki、Irie Hiroki、Obara Katsutoshi、Ohira Hiromasa
  • Journal Title: Clinical Journal of Gastroenterology Volume: 11 Issue: 4 Pages: 273-277
  • DOI: 10.1007/s12328-018-0819-7
• [Journal Article] Management of achalasia cardia: Expert consensus statements (2018)
  • Author(s): Ramchandani Mohan、Nageshwar Reddy D、Nabi Zaheer、Chavan Radhika、Bapaye Amol、Bhatia Shobna、Mehta Nilay、Dhawan Pankaj、Chaudhary Adarsh、Ghoshal Uday C、Philip Mathew、Neuhaus Horst、Deviere Jacques、Inoue Haruhiro
  • Journal Title: Journal of Gastroenterology and Hepatology Volume: 33 Issue: 8 Pages: 1436-1444
  • DOI: 10.1111/jgh.14097
• [Journal Article] Current status of achalasia management: a review on diagnosis and treatment (2017)
  • Author(s): Tuason J, Inoue H
  • Journal Title: Journal of Gastroenterology Volume: 52 Pages: 401-406
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Presentation] 食道良性疾患に対する新しい内視鏡診断と治療 (2019)
  • Author(s): 井上晴洋
  • Organizer: 第73回日本食道学会学術集会
• [Presentation] The 10th anniversary of POEM development (2019)
  • Author(s): 井上晴洋
  • Organizer: 第96回日本消化器内視鏡学会総会
• [Presentation] 食道良性疾患に対する新しい内視鏡診断と治療 (2019)
  • Author(s): 井上晴洋
  • Organizer: 第111回日本消化器病学会中国支部例会
• [Presentation] 食道良性疾患に対する最新の内視鏡診断と治療 (2018)
  • Author(s): 井上晴洋
  • Organizer: 第95回日本消化器内視鏡学会総会
• [Presentation] アカラシアに対するPOEMの更なる展開―1500例の成績とPOEM＋F（逆流防止付加）の開発― (2018)
  • Author(s): 井上晴洋
  • Organizer: 第72回日本食道学会
• [Presentation] 難治性GERDに対する新しい内視鏡診断（EPSIS）と内視鏡治療（ARMS） (2018)
  • Author(s): 井上晴洋
  • Organizer: 第72回日本食道学会
• [Presentation] Intraluminal endoscopic surgery for esophageal bening desease:POEM for achalasia, POET for submucosal tumor, ARMS for PPI resistant GERD (2018)
  • Author(s): 井上晴洋
  • Organizer: 第31回日本内視鏡外科学会総会
• [Presentation] 食道アカラシアPOEM後の難治性逆流性食道炎に対してARMSでコントロールできた2症例 (2017)
  • Author(s): 池淵雄一郎、井上晴洋
  • Organizer: 第71回日本食道学会総会
• [Presentation] 食道疾患内視鏡治療ーPOEM、ARMS- (2017)
  • Author(s): 井上晴洋
  • Organizer: 第30回日本内視鏡外科学会
  • Invited
• [Presentation] 内視鏡診断と治療 (2017)
  • Author(s): 井上晴洋
  • Organizer: 第55回日本癌治療学会総会
  • Invited
• [Book] 医学のあゆみ (2020)
  • Author(s): 井上晴洋
  • Total Pages: 4
  • Publisher: 医歯薬出版(株)
• [Book] 月刊消化器内科 (2020)
  • Author(s): 井上晴洋
  • Total Pages: 1
  • Publisher: 医学出版
• [Book] 臨床外科 (2018)
  • Author(s): 井上晴洋
  • Total Pages: 6
  • Publisher: 南江堂
• [Book] 消化器内視鏡 (2017)
  • Author(s): 井上晴洋
  • Total Pages: 6
  • Publisher: 東京医学社