Published online May 7, 2025. doi: 10.3748/wjg.v31.i17.104579
Revised: March 22, 2025
Accepted: April 18, 2025
Published online: May 7, 2025
Processing time: 125 Days and 20.2 Hours
Peroral endoscopic myotomy (POEM) has emerged as the first-line therapy for achalasia. However, large-scale studies which examine sex-related differences in symptoms and outcomes remain limited.
To evaluate the impact of sex on achalasia symptoms, diagnostic findings, and postoperative improvement following POEM.
We conducted a retrospective review of achalasia patients who underwent POEM at a large center between 2010 and 2020, analyzing demographics and variables collected before, during, and after the procedure for both female and male cases.
Our study included 526 cases in total, with the female group experiencing more severe chest pain (P = 0.008). After stratifying age, we found that women aged 40 to 60 showed higher chest pain scores compared to their male counterparts. In female cases, the severity of dysphagia before POEM was lowest among those aged 60 and older (P = 0.033). Preoperatively, the integrated relaxation pressure (IRP) and resting lower esophageal sphincter pressure (LESP) were higher in the female group compared to the male group (P < 0.001 and P = 0.001, respectively). However, no differences in postoperative IRP and LESP were observed between two groups. The overall efficiency of POEM was 96.52%, with a significant impro
Sex may influence the severity and frequency of chest pain, with female cases exhibiting higher LESP and IRP compared to male cases. POEM is proven to be a safe and effective procedure for both sexes, with female cases potentially experiencing greater benefits.
Core Tip: This is the first study that aimed to evaluate the impact of sex on achalasia symptoms, diagnostic findings, and postoperative improvement following peroral endoscopic myotomy (POEM). Our study drew a conclusion that sex may influence the severity and frequency of chest pain, with female cases exhibiting higher lower esophageal sphincter pressure and integrated relaxation pressure compared to male cases. POEM is proven to be a safe and effective procedure for both sexes, with female cases potentially experiencing greater benefits.