Comparison of clinical outcomes among different endoscopic myotomy techniques for achalasia
10.3760/cma.j.cn321463-20241212-00444
- VernacularTitle:内镜下肌切开不同术式治疗贲门失弛缓症的临床效果比较
- Author:
Yingfan LI
1
;
Tao GUO
1
;
Xiaoqing LI
1
;
Yaowen HU
1
;
Xi WU
1
;
Qingwei JIANG
1
;
Aiming YANG
1
Author Information
1. 中国医学科学院北京协和医学院 北京协和医院消化内科，北京 100730
- Publication Type:Journal Article
- Keywords:
Cardia;
Achalasia;
Peroral endoscopic myotomy;
Short myotomy;
Full-thickness myotomy
- From:
Chinese Journal of Digestive Endoscopy
2025;42(8):616-621
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy and safety of different myotomy procedures during peroral endoscopic myotomy (POEM) for achalasia (AC).Methods:A retrospective study was conducted involving patients diagnosed as having achalasia and underwent POEM at Peking Union Medical College Hospital from April 2020 to October 2023. Patients were divided into conventional myotomy group, short myotomy group and full-thickness myotomy group according to myotomy length and depth. Outcomes including operation duration, procedure-related complications, efficacy and incidence of postoperative reflux esophagitis were compared between conventional vs. short, and conventional vs. full-thickness groups.Results:Among 70 patients, 26 underwent conventional myotomy, 19 short myotomy, and 25 full-thickness myotomy. The short myotomy group demonstrated significantly shorter procedure duration (72.89±20.57 min) compared to the conventional group (91.81±36.70 min, t=2.197, P=0.034). There were no statistically significant differences in procedure-related complications [26.3% (5/19) VS 34.6% (9/26), χ2=0.353, P=0.553], treatment efficacy [94.7% (18/19) VS 96.2% (25/26), χ2=0.052, P=0.820], or incidence of postoperative reflux esophagitis [50.0% (5/10) VS 41.7% (5/12), χ2=0.306, P=0.580] between the short and conventional myotomy groups. No statistically significant differences were observed between the conventional and full-thickness myotomy group in procedure duration (99.64±29.13 min VS 91.81±36.70 min, t=0.336, P=0.404), procedure-related complications [28.0% (7/25) VS 34.6% (9/26), χ2=0.259, P=0.611], treatment efficacy [96.0% (24/25) VS 96.2% (25/26), χ2=0.001, P=0.977], or incidence of postoperative reflux esophagitis [35.7% (5/14) VS 41.7% (5/12), χ2=0.022, P=0.883]. Conclusion:Short myotomy POEM achieves comparable efficacy to conventional myotomy with reduced operative time and no increased complication risk. Full-thickness myotomy demonstrates similar efficacy, operative duration, and safety to conventional myotomy.
