POEM vs. Pneumatic Dilation for Initial Achalasia Treatment

The first randomized trial comparing these treatment approaches favors POEM at 2-year follow-up.

In patients with an acceptable risk profile, achalasia treatment can be accomplished surgically via laparoscopic Heller myotomy (LHM) or endoscopically via pneumatic dilation (PD) or the newer peroral endoscopic myotomy (POEM) approach. A prior randomized, controlled trial found similar outcomes between PD and LHM. Now, investigators report results of the first randomized, controlled trial of PD versus POEM for initial treatment of achalasia in 133 patients.

The primary outcome of treatment success (an improvement in the Eckardt symptom score [to ≤3] and absence of severe complications or retreatment) at 2 years' follow-up was higher with POEM compared with PD (92% vs. 54%). The PD recipients were more likely to have an elevated Eckardt scor…

Reviewing Author

Kenneth R. DeVault, MD

Disclosures

Consultant/Advisory BoardPhathom Pharmaceuticals

Grant/Research SupportIronwood Pharmaceuticals

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology Education Universe (Co-Editor)

Kenneth R. DeVault, MD

Disclosures

Consultant/Advisory BoardPhathom Pharmaceuticals

Grant/Research SupportIronwood Pharmaceuticals

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology Education Universe (Co-Editor)

POEM vs. Pneumatic Dilation for Initial Achalasia Treatment

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Reviewing Author