Long-term outcomes of per-oral endoscopic myotomy compared to laparoscopic Heller myotomy for achalasia: a single-center experience.

Surgical Endoscopy
Alexander J PodboyJohn O Clarke

Abstract

Many centers have reported excellent short-term efficacy of per-oral endoscopic myotomy (POEM) for the treatment of achalasia. However, long-term data are limited and there are few studies comparing the efficacy of POEM versus Heller Myotomy (HM). To compare the long-term clinical efficacy of POEM versus HM. Using a retrospective, parallel cohort design, all cases of POEM or HM for achalasia between 2010 and 2015 were assessed. Clinical failure was defined as (a) Eckardt Score > 3 for at least 4 weeks, (b) achalasia-related hospitalization, or (c) repeat intervention. All index manometries were classified via Chicago Classification v3. Pre-procedural clinical, manometric, radiographic data, and procedural data were reviewed. 98 patients were identified (55 POEM, 43 Heller) with mean follow-up of 3.94 years, and 5.44 years, respectively. 83.7% of HM patients underwent associated anti-reflux wrap (Toupet or Dor). Baseline clinical, demographic, radiographic, and manometric data were similar between the groups. There was no statistical difference in overall long-term success (POEM 72.7%, HM 65.1% p = 0.417, although higher rates of success were seen in Type III Achalasia in POEM vs Heller (53.3% vs 44.4%, p < 0.05). Type III Achal...Continue Reading

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Jan 6, 2021·Surgical Endoscopy·Sarah C McKayLee L Swanström
Apr 30, 2021·Annals of Surgery·Ryan A J CampagnaEric S Hungness
Apr 17, 2021·Current Opinion in Gastroenterology·Sara NullensAlbert J Bredenoord
Aug 14, 2021·Current Opinion in Gastroenterology·Zaheer Nabi, D Nageshwar Reddy

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