Comparative Outcomes of Peroral Endoscopic Myotomy and Pneumatic Dilation in Patients with Achalasia Cardia: A Single-Center Retrospective Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction Peroral endoscopic myotomy (POEM) and pneumatic dilation (PD) are established treatment options for achalasia cardia. Comparative data from Indian centers remain limited. We evaluated the short-term efficacy and safety of POEM and PD in patients treated at a tertiary care center. Methods This retrospective study included 30 patients with achalasia cardia treated between June 2024 and May 2026. Fifteen patients underwent POEM and 15 underwent PD. Demographic characteristics, achalasia subtype, procedural outcomes, symptom improvement, adverse events, and postprocedure reflux symptoms were analyzed. Clinical success was defined as an Eckardt score < 3 at 6 months. Results The POEM group comprised 15 patients (10 males, 5 females), while the PD group included 15 patients (9 males, 6 females). Baseline characteristics and mean Eckardt scores were comparable between groups (8.2 vs. 8.0). Type I and type II achalasia constituted the majority of cases in both groups. Technical success was achieved in all patients. At 6 months, clinical success was observed in 14 of 15 patients (93.3%) in the POEM group compared with 13 of 15 patients (86.7%) in the PD group. Mean hospital stay was longer following POEM (2.3 vs. 1.1 days). Gastroesophageal reflux symptoms occurred more frequently after POEM than after PD (26.7% vs. 6.7%). Follow-up endoscopy demonstrated esophagitis in three patients following POEM and one patient following PD. No major complications, including perforation, significant bleeding, mediastinitis, or procedure-related mortality, were encountered in either group. Conclusion Both POEM and PD were safe and effective treatment modalities for achalasia cardia. POEM demonstrated numerically higher short-term clinical success, whereas PD was associated with a lower incidence of reflux symptoms and shorter hospital stay. Larger prospective studies with longer follow-up are required to validate these findings. Publication History Article published online: 27 August 2026 © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical and Scientific Publishers Private Limited A-13A, Graphix Tower 1, 6th floor, Sector 62, Noida 201309, Uttar Pradesh, India
Source: Journal of Digestive Endoscopy
Institution: Kurnool Medical College
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204434893