Peroral Endoscopic Myotomy Improves Esophageal Body Motility in Patients With Short Achalasia Duration: 1886

Introduction: To assess the esophageal body motility in a group of 66 patients with achalasia of the cardia undergoing peroral endoscopic myotomy (POEM) and to analyze the factors involved in this phenomenon. Methods: The study group comprised 60 patients with achalasia of cardia,the patients underwent peroral endoscopic myotomy at our Digestive Endoscopic Center and did pre- and post-operative high-resolution manometry within 1-6 month. Of these patients, 49 (81.6%) had no changes between the pre- and post-operative esophageal body motility, the remaining 11 (18.4%) patients’ lower esophageal sphincter (LES) residual pressure, distal contraction integral (DCI), contraction of front velocity (CFV), synchronous contraction percentage were analyzed on the remaining 11 patients whose esophageal body motility data had changed. In addition, a statistical comparison of duration of symptoms was made between the 11 and 49 patients. Results: 1) In 16.7% of the patients after POEM, LES residual pressure (30.12±8.56 vs 17.13±7.60,P<0.05),DCI (3533.95±3704.15 vs. 1034.06±892.89,P<0.05) and synchronous contraction percentage (69.09±27.12 vs. 42.73±31.36,P<0.05) decreased, and the difference was statistically significant, contraction front velocity (CFV) mean value reduced but the difference was not statistically significant (25.8 ±77.89 vs4.02±25.04,P>0.05),and 4 cases presented a return of peristalsis; 2) The duration of patients with esophageal body motility improving was significantly shorter than the patients without esophageal body motility improving (1.53±0.96 vs. 6.37±7.05,P<0.05), and the difference was statistically significant. Conclusion: 1) POEM can improve esophageal body motility in a certain group of patients with achalasia in the short term(1-6 month); 2) Peroral endoscopic myotomy improves esophageal body motility in patients with short achalasia duration.Figure 1