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Updated: Aug 5, 2026
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Published on: August 11, 2023
Peroral Endoscopic Myotomy for Pediatric Achalasia: 36-Month Outcomes from a Single-Center Cohort Study
Yuling Feng1, Xiang Ren2, Zhujun Gu1
1Department of Digestive Endoscopy Center, School of Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China.
Insights
Peroral endoscopic myotomy (POEM) is a safe and effective treatment for achalasia in children, showing sustained clinical success at 36 months. This minimally invasive procedure improved patient outcomes and nutritional status.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Surgery
- Esophageal Motility Disorders
Background:
- Limited long-term data exist for peroral endoscopic myotomy (POEM) in pediatric achalasia.
- Achalasia in children requires effective and safe long-term treatment options.
Purpose of the Study:
- To evaluate the 36-month safety and efficacy of POEM in children diagnosed with achalasia.
- To assess the long-term impact of POEM on clinical outcomes and patient well-being.
Main Methods:
- Retrospective cohort study of pediatric achalasia patients undergoing POEM.
- Primary outcome: clinical success defined by Eckardt score ≤ 3.
- Secondary outcomes: changes in Eckardt score, timed barium esophagram (TBE), body mass index (BMI) z score, and adverse events.
Main Results:
- Thirty children (mean age 11.15 years) with a median follow-up of 36 months were analyzed.
- 93.3% of patients achieved clinical success, with significant reductions in Eckardt scores and TBE findings.
- No major adverse events were reported; BMI z score showed a significant increase.
Conclusions:
- POEM demonstrates a favorable safety profile and sustained efficacy in treating pediatric achalasia up to 36 months.
- The procedure leads to significant symptom improvement and nutritional status enhancement in children.
Background And Aims:
Long-term data on peroral endoscopic myotomy (POEM) in children with achalasia remain limited. We aimed to evaluate the safety and 36-month efficacy of POEM in pediatric achalasia.
Methods:
Consecutive children with achalasia who underwent POEM were included in this retrospective cohort study. The primary outcome was clinical success (Eckardt score ≤ 3). Secondary outcomes included changes in Eckardt score, timed barium esophagram (TBE) findings, body mass index z score, and adverse events.
Results:
Thirty children were included (mean age, 11.15 ± 2.68 years) with a median follow-up of 36 months (range, 6-66 months). During the available follow-up period, clinical success was achieved in in 93.3% of patients. Eckardt scores and TBE showed significant reductions, and body mass index z score increased. No major adverse events occurred.
Conclusions:
POEM appears to be a safe and effective treatment for pediatric achalasia, with favorable outcomes sustained at 36 months.
