Peroral Endoscopic Myotomy for Type III Achalasia of Chicago Classification: Outcomes with a Minimum Follow-Up of 24 Months.
There are only few studies about the outcomes of peroral endoscopic myotomy (POEM) for type III achalasia in a relatively large population to date. The purpose of this study was to explore the long-term efficacy of POEM for patients with type III achalasia.



There were a total of 32 consecutive patients with type III achalasia undergoing POEM in our hospital from July 2012 to October 2014. Clinical date of general characteristics, procedure-related parameters and adverse events, symptom relief, and the high-resolution manometry outcomes before and during the periodic follow-up were retrospectively collected and analyzed.



All of the 32 patients underwent POEM successfully with a median operation time of 34.9 min (range 17.9-88.6 min). No serious complications related to POEM were encountered. Treatment success was achieved in 90.6% cases during a median follow-up period of 27.0 months (range 24-51 months). The mean pretreatment and post-treatment Eckardt scores were 7.2 and 1.4, respectively (P < 0.001), and mean LES pressure also decreased from a mean of 39.2 to 19.0 mmHg after the procedure (P < 0.001). Both of the gas-related complication and clinical reflux complication rates were 18.8%.



Our results confirm that POEM for type III achalasia of Chicago Classification is effective with a long-term symptom relief in 90.6% cases. But a further, prospective study is needed to evaluate whether POEM outcome could be correlated with manometric subtypes according to Chicago Classification.
Department of Gastroenterology, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China.
Wengang
W
Zhang
Department of Gastroenterology, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China. linghuenqiang@vip.sina.com.
En-Qiang
EQ
Linghu
D000293:Adolescent; D000328:Adult; D000368:Aged; D004931:Esophageal Achalasia / Q000145:classification / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
Achalasia; Chicago Classification; Peroral endoscopic myotomy