47. PERORAL ENDOSCOPIC MYOTOMY VS HELLER MYOTOMY WITH FUNDOPLICATION IN OUR CENTER

Abstract Heller myotomy with fundoplication (HF) is one of the established treatments for esophageal achalasia. However, less invasive Peroral endoscopic (POEM) rapidly spreading. Several papers report short-term efficacy and safety POEM as well HF, but GERD more frequent after POEM. Moreover, long-term outcome still unknown. This a single center retrospective study. In our center, HF was carried out 59 patients between 1999 2014. Among them, 58 cases underwent laparoscopic procedure, 52 were Dor 7 Toupet. From 2015 we performed 224 until Dec 2022. For POEM, grade dilatation lower (I/II/III=POEM;76/131/17, HF;6/44/9, p < 0.001) length longer (8.5 ± 3.4 cm vs 5.7 0.8 cm, P 0.001). Median IRP Eckardt score decreased them (24.3 13.0 to 7.8 4.8 mmHg/5.37 2.09 0.54 0.84). improved their LES pressure (40.2 20.3 18.0 7.1 mmHg, Postoperative LA B often (26.9% 4.7%, 0.001), however C or D comparable. All controlled by PPIs, except patient considering further treatment. median follow-up period (78 19 mo), however, additional treatment necessary (6.8% 1.3%, = 0.033). common almost all PPIs. likely require treatment, though time relatively short. Further observation re-evaluation are warranted.