Sa1280 CLINICAL EFFICACY OF ANTERIOR VS POSTERIOR PER ORAL ENDOSCOPIC MYOTOMY TWO YEARS POST-PROCEDURE: PROSPECTIVE RESULTS FROM A RANDOMIZED CLINICAL TRIAL

Abstract

Peroral endoscopic myotomy (POEM) has become a well-established management option for patients with achalasia. POEM can be performed either using the anterior approach (1-2 o’clock orientation) or posterior approach (5-6 o’clock position). Knowledge of the optimal approach (superior efficacy and safety and lower risk of GERD) is crucial. We have previously shown in a randomized clinical trial (RCT) that the posterior approach was non-inferior to the anterior approach at 1-year post POEM in terms of clinical success, rate of adverse events, and risk of GERD. Aims: To compare the rate of clinical success (Eckardt score < 3) of anterior vs posterior approaches at 24-month post-POEM. Secondary objectives include comparison of dysphagia score, GerdQ score and PPI use between both groups.