SAN DIEGO—Per-oral endoscopic myotomy showed promising safety and efficacy as a treatment for achalasia in children in a single-center retrospective study presented at DDW 2025.
Pediatric patients with achalasia who were treated with POEM at Nationwide Children’s Hospital, in Columbus, Ohio, between May 2023 and May 2024 were included in the study. The investigators evaluated changes in Eckardt score, lower esophageal sphincter (LES) diameter, distensibility index (DI), and weight pre- and post-POEM (abstract Sa2119).
Among 12 patients included in the study, 10 (77%) were male and the median age was 13.2 years. The majority of patients (66.7%) had type II achalasia, with the remaining having either type I or III. On average, patients were evaluated 3.8 months after POEM.
Eckardt score, mean intraoperative functional luminal imaging probe (FLIP) LES diameter and mean intraoperative FLIP DI all significantly improved from baseline to follow-up (P<0.001) (Table). In addition, patient weight increased by 5.5 kg at follow-up (P=0.259).
| Table. POEM Efficacy in Pediatric Patients | ||
| Measure | Pre-POEM | Post-POEM |
|---|---|---|
| Eckardt score (median [range]) | 8 [5-10] | 0 [0-2] |
| LES diameter, mm | 12.1 | 17.4 |
| DI, mm2/mm Hg | 2.1 | 5.2 |
| DI, distensibility index; LES, lower esophageal sphincter; POEM, per-oral endoscopic myotomy. | ||
Patients stayed in the hospital for a median of one day after POEM, and there were no significant complications during or after the procedure for any patient.
The investigators noted that future studies should evaluate the “long-term durability of [POEM], interval development of significant reflux [and correlate] each to LES function via FLIP.”
—Natasha Albaneze, MPH