Analysis of the Effect of POEM Operation on Patients with Type-cardiac Achalasia

LI Qianqian; NING Huahan; LI Chenyu; LU Miaomiao; LI Yanrong

doi:10.3969/j.issn.2096-305X.2025.02.014

Abstract：Objective This study aims to examine the impact of Peroral Endoscopic Myotomy(POEM)on esophageal functional parameters and clinical symptoms in patients with achalasia(AC)categorized by different pressure subtypes,thereby providing a comprehensive assessment of the therapeutic efficacy of the POEM procedure for various AC patient groups.Methods A total of 20 AC patients meeting the inclusion criteria were selected,including 10 males and 10 females.The patients were divided into 6 patients with type Ⅰ AC and 14 patients with type Ⅱ AC by preoperative esophageal manometry and reference to Chicago classification.All patients received POEM surgery,and Eckardt scoring method was used to evaluate the improvement of preoperative and postoperative symptoms.Through high resolution manometry,the changes of lower esophageal sphincter pressure(LESP)and lower esophageal sphincter length(LESL)before and after surgery were compared between the two groups.Results There was no significant difference in intraoperative complications,postoperative complications and adverse reactions between the two types of AC patients(P＞0.05).After POEM,the improvement of POEM symptoms in type Ⅱ patients was more significant than that in type Ⅰ patients(P=0.010).The pressure reduction of type Ⅱ was more significant than that of type Ⅰ(P=0.020).There was no significant difference in LESL parameters(P=0.350).Conclusion There was no significant difference in intraoperative and postoperative complications and adverse reactions between the two types of AC patients with POEM.POEM has a significant effect on both type Ⅰ and type Ⅱ AC patients,but the remission degree of LESP parameters in postoperative Eckardt score and HRM detection is more obvious in type Ⅱpatients.