Efficacy and safety analysis of short tunnel peroral endoscopic myotomy in the treatment of achalasia

Objective To compare the efficacy and safety between short tunnel and standard tunnel peroral endoscopic myotomy(POEM) in the treatment of achalasia, and provide the theoretical basis for the individual selection of POEM surgical program.

Methods The clinical data of 40 patients with achalasia were retrospectively analyzed.According to the distance of the tunnel opening away gastroesophageal junction(GEJ) position, the patients were divided into the short tunnel group and standard tunnel group.The clinical efficacy, operative time, length of tunnel, length of muscle incision and complications were compared between two groups.

Results The total tunnel length, length of muscle incision and operation time in short tunnel group were shorter than those in standard tunnel group(P<0.05 to P<0.01), and the difference of average tunnel length under GEJ between two groups was not statistically significant(P>0.05).The differences of mucosal perforation rate, incidence rate of gas-related complications, fever rate, postoperative following-up time, postoperative Eckardt score, postoperative 3 months increasing of body mass and postoperative GERD incidence rate between two groups were not statistically significant(P>0.05).

Conclusions The achalasia patients treated with short tunnel POEM does not increase the incidence rate of postoperative complications, which is safe and effective during the short-term following up.