title: Peroral endoscopic myotomy can improve esophageal motility in patients with achalasia from a large sample self-control research (66 patients).
abstract: BACKGROUND
  Peroral endoscopic myotomy (POEM) as a new approach to achalasia attracts broad attention. The primary objective of this study was to evaluate the results with esophageal motility after POEM through the first large sample clinical research.
  
  
  METHODS
  We have a self-control research with all patients (205 in total) who underwent POEM from 2010 to 2014 at our Digestive Endoscopic Center, 66 patients of which underwent high resolution manometry (HRM) before and after POEM in our motility laboratory. Follow-ups last for 5.6 months on average. Outcome variables analyzed included upper esophageal sphincter pressure (UESP), upper esophageal sphincter residual pressure (UESRP), lower esophageal sphincter pressure (LESP), lower esophageal sphincter residual pressure (LESRP) and esophageal body peristalsis. We have a statistical analysis to illustrate how POEM impacts on the change of esophageal motility.
  
  
  RESULTS
  The symptoms related to dysphagia were relieved in 95% of patients in recent term after POEM. While HRM showed a statistically significant reduction of URSRP, LESP and LESRP (P<0.01), however, peristalsis was not consistently affected. There were 11 patients who had undergone other prior endoscopic treatment (endoscopic dilation or botulinum toxin injection) and 55 patients had not. The statistical difference (P>0.05) did not occur for these two groups on LESP and LESRP reduction.
  
  
  CONCLUSIONS
  POEM clearly relieved the symptoms related to dysphagia by lowering the pressure of upper esophageal sphincter (UES) and lower esophageal sphincter (LES),and other endoscopic treatment before POEM did not affect the improvement of LES pressure. These results are concluded from our short-term follow-up study, while the long-term efficacy remains to be further illustrated.
  
  
  BACKGROUND
  Chinese Clinical Trial Register ChiCTR-TRC-12002204).
authors.affiliation: Department of Gastroenterology, Chinese People's Liberation Army General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China.
authors.forename: Shuangzhe
authors.initials: S
authors.lastname: Yao
authors.affiliation: Department of Gastroenterology, Chinese People's Liberation Army General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China.
authors.forename: Enqiang
authors.initials: E
authors.lastname: Linghu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000503:physiopathology / Q000601:surgery*; D004931:Esophageal Achalasia / Q000503:physiopathology / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology / Q000601:surgery; D049631:Esophageal Sphincter, Upper / Q000503:physiopathology / Q000601:surgery; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis; D011312:Pressure; D000068356:Self-Control; D016896:Treatment Outcome; D055815:Young Adult