Clinical efficacy and safety of short-length peroral endoscopic myotomy (POEM) compared with long-length myotomy for the treatment of achalasia.
Background: Previous evidence suggests that a short myotomy does not reduce the efficacy of peroral endoscopic myotomy (POEM) or increase intraoperative complications. However, the available studies are still limited and there has been no research in Latin America. Objectives: This study aims to eva...
| Publicado en: | Therapeutic Advances in Gastrointestinal Endoscopy Vol. 19; pp. 1 - 13 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
3/16/2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192372934&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 192372934 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 26317745 M8AA jtl: Therapeutic Advances in Gastrointestinal Endoscopy issn: 26317745 maglogo: Y pubinfo: dt: 3/16/2026 vid: 19 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 192372934 192372934 192372934 10.1177/26317745261433142 192372934 ppf: 1 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Clinical efficacy and safety of short-length peroral endoscopic myotomy (POEM) compared with long-length myotomy for the treatment of achalasia. aug: au: Dávila-Ruales, Valentina Vergara, Hernando J. Muñoz, Oscar M. Castañeda, Alexander Vargas, Rómulo D. Rodríguez, Jesús A. affil: Conceptualization, Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Kra 7 No. 40-62, Bogotá 110231, Colombia Gastroenterology Unit, Hospital Universitario San Ignacio, Bogotá, Colombia sug: subj: Peroral Endoscopic Myotomy Methods Esophageal Achalasia Surgery Treatment Outcomes Patient Safety Referral and Consultation Colombia Human Colombia Male Female Adult Middle Age Retrospective Design Prospective Studies Comparative Studies Descriptive Statistics T-Tests Chi Square Test Mann-Whitney U Test Data Analysis Software Scales Postoperative Complications Emphysema Abdomen Punctures Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Background: Previous evidence suggests that a short myotomy does not reduce the efficacy of peroral endoscopic myotomy (POEM) or increase intraoperative complications. However, the available studies are still limited and there has been no research in Latin America. Objectives: This study aims to evaluate whether POEM with a short myotomy differs significantly from a long myotomy in terms of efficacy and safety in patients with achalasia. Design/Methods: A retrospective cohort study including patients who underwent POEM for achalasia between 2017 and 2024. Efficacy was assessed according to the Eckardt scale at 6 months and at 1 year of follow-up. Safety was assessed for perioperative adverse events according to the iPOEM classification. Results: A total of 57 patients were included, 44% underwent short myotomy (median esophageal length of 5 cm; interquartile range (IQR) 4–5), and 56% long myotomy (median 11 cm IQR 10–13). 35% had previously undergone surgery for achalasia. The long myotomy group had more frequently minor complications such as emphysema (15.6% vs 0%; p = 0.039), capnoperitoneum (65.6% vs 16.0%, p < 0.001) and required more abdominal punctures (56.2% vs 12.0%, p < 0.001). There was no difference in the incidence of other complications. The probability of symptomatic response, defined as an Eckardt score ⩽ 3 at 12 months, was similar between groups (84.3% vs 88%, p = 0.69). The median operative time for the short myotomy was shorter (median 80 min; IQR 70–95 vs 127.5 min; IQR 102–155 min; p < 0.001). Conclusion: Short myotomy is not inferior to long myotomy in terms of clinical success and long-term reflux disease in the management of patients with achalasia. Furthermore, it offers advantages such as shorter procedure times and potentially lower rates of minor complications, making it the preferred option in most cases. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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