Effect and safety of mark-guided vs standard peroral endoscopic myotomy: A retrospective case control study

Table 1 Baseline characteristics and comparison of procedurerelated parameters

Characteristics	Mark-guided POEM (n = 64)	Standard POEM (n = 69)	P value
Sex
Male (n)	33 (51.6%)	36 (52.2%)	0.94
Female (n)	31 (48.4%)	33 (47.8%)
Age (yr)	33.5 (28-48.75)	40 (30-47.75)	0.22
Achalasia Type
I	21 (32.8%)	23 (33.3%)	0.98
II	36 (56.3%)	38 (55.1%)
III	7 (10.9%)	8 (11.6%)
Disease duration (mo)	32.5 (23-49.50)	33 (22.5-49.50)	0.95
Eckardt score	9.0 (8-9.75)	8.0 (7-9)	0.32
Barium esophagraphy
Height (cm)	8 (8-9)	8 (7-9)	0.55
Diameter (cm)	5 (4-6)	5 (5-6)	0.29
HRM (mmHg)	38 (28-41)	38 (28-41.5)	0.64
GERDQ score	7 (6-9)	7 (6-8.5)	0.74
SF-36 score	47.22 ± 7.25	46.81 ± 7.60	0.75
Procedure duration (min)	40 (38-43)	49 (47-51)	< 0.001
Technical success (n)	64 (100%)	69 (100%)	1
Postoperative stay (d)	1 (1-2)	1 (1-2)	0.56
Perforation (n)	0	0	1
Bleeding (n)	0	0	1

POEM: Peroral endoscopic myotomy; HRM: High-resolution manometry; GERDQ: Gastroesophageal reflux disease questionnaire; SF-36: 36-Item Short-Form Health Survey.

Table 2 Primary and secondary outcomes in patients at 3 mo follow-up

	Mark-guided POEM (n = 64)	Standard POEM (n = 69)	P value
Overall clinical success (n)	63 (98.4%)	68 (98.6%)	0.3
Eckart score	1 (1-2)	1 (1-2)	0.78
GERDQ score	6 (5-9)	6 (5-7)	0.35
SF-36 score	78 (76-80)	78 (75-80.5)	0.87
Barium esophagraphy
Height (cm)	3 (2-4)	3 (2-4)	0.94
Diameter (cm)	2 (2-2.5)	2 (2-2.75)	0.86
HRM (mmHg)	12.2 ± 2.37	12.06 ± 1.93	0.7
Reflux symptom (n)
Yes	7 (10.9%)	17 (24.6%)	0.04
No	57 (89.1%)	52(75.4%)
PPI use (n)
Yes	8 (12.7%)	19 (27.5%)	0.03
No	56 (87.3%)	60 (72.5%)

POEM: Peroral endoscopic myotomy; HRM: High-resolution manometry; GERDQ: Gastroesophageal reflux disease questionnaire; SF-36: 36-Item Short-Form Health Survey; PPI: Proton pump inhibitor.

Table 3 Primary and secondary outcomes in patients at 12 mo follow-up

	Mark-guided POEM (n = 59)	Standard POEM (n = 59)	P value
Overall clinical success (n)	55 (93.2%)	54 (91.5%)	0.73
Eckart score	1 (1-2)	1 (1-2)	0.9
GERDQ score	7 (6-9)	6 (6-9)	0.67
SF-36 score	75 (67-78)	74 (70-78)	0.94
Reflux symptom (n)
Yes	10 (16.9%)	22 (37.3%)	0.01
No	49 (83.1%)	37 (62.7%)
PPI use (n)
Yes	11 (18.6%)	24 (40.7%)	0.009
No	48 (81.4%)	35 (59.3%)

POEM: Peroral endoscopic myotomy; GERDQ: Gastroesophageal reflux disease questionnaire; SF-36: 36-Item Short-Form Health Survey; PPI: Proton pump inhibitor.

Table 4 Primary and secondary outcomes in patients at 24 mo follow-up

	Mark-guided POEM (n = 48)	Standard POEM (n = 51)	P value
Overall clinical success (n)	44 (92.7%)	47 (92.2%)	0.93
Eckart score	1 (1-2)	1 (1-2)	0.92
GERDQ score	7 (6-9)	7 (6-9)	0.74
SF-36 score	77 (71-80)	76 (72-80)	0.73
Reflux symptom (n)
Yes	13 (27.1%)	24(47.1%)	0.04
No	35(72.9%)	27 (52.9%)
PPI use (n)
Yes	14 (29.2%)	26 (51%)	0.02
No	34 (70.8%)	25 (49%)

POEM: Peroral endoscopic myotomy; GERDQ: Gastroesophageal reflux disease questionnaire; SF-36: 36-Item Short-Form Health Survey; PPI: Proton pump inhibitor.