Study protocol
achalasia
RECURRENCE, ACHALASIA, DILATION, OESOPHAGEAL CANCER
All patients referred for POEM as a treatment of achalasia during a 3-year period (from June 2015 to September 2018) were included in this monocentric retrospective study carried out at a tertiary referral centre (University Hospital of Nantes, France) (Fig. Flow-chart of the study. Patients without any previous specific treatment of achalasia (naïve patients) were offered different options after full verbal information concerning classical therapies (botulinum toxin, endoscopic dilation or surgery) and POEM. The POEM1 group consisted of naïve patients currently treated by POEM as a first-line therapy. Another group of patients with achalasia was referred for POEM because of the recurrence of symptoms after receiving classical treatments. After providing information and clinical evaluation, the indication of POEM therapy was confirmed and the patients were included in the POEM2 group, excluding those with previous POEM history.Patients with oesophageal cancer, history of oesophageal surgery (other than Heller’s myotomy) or with a follow-up of less than 6 months were excluded.