BACKGROUND _ AIMS: In @entity1 with persistent symptoms after Heller myotomy ( @entity3257 ), treatment options include  repeat @entity3257 , @entity384 , or peroral endoscopic myotomy (POEM). We evaluated  the efficacy and safety of POEM in @entity1 with @entity1318 with prior @entity3257 vs without prior  @entity3257 . METHODS: We conducted a retrospective cohort study of 180 @entity1 with @entity1318 who underwent POEM at 13 tertiary centers worldwide, from December 2009 through September 2015. @entity1 were divided into 2 groups: those with prior @entity3257 ( @entity3257 group, exposure; n  = 90) and those without prior @entity3257 ( @entity3257 ; n  = 90). Clinical response was defined by a decrease in Eckardt scores to 3 or less. Adverse events were graded according to criteria set by the American Society for Gastrointestinal Endoscopy. Technical success, clinical success, and rates of adverse events were compared between groups. @entity1 were followed up for a median of 8.5 months. RESULTS: POEM was technically successful in 98% of @entity1 in the @entity3257 group and in 100% of @entity1 in the @entity3257 (P  = .49). A significantly lower proportion of @entity1 in the @entity3257 group had a clinical response to POEM (81%) than in the @entity3257 (94%; P  = .01). There were no significant differences in rates of adverse events between the groups (8% in the @entity3257 group vs 13% in the @entity3257 ; P  = .23). Symptomatic reflux and @entity354 after POEM were comparable between groups. CONCLUSIONS: POEM is safe and effective for @entity1 with @entity1318 who were not treated successfully by prior @entity3257 . Although the rate of clinical success in @entity1 with prior @entity3257 is lower than in those without prior @entity3257 , the safety profile of POEM is comparable between groups.

Efficacy and Safety of Peroral Endoscopic Myotomy for Treatment of XXXX After Failed Heller Myotomy.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1318 :: ('MESH:D004931', 'Disease') :: ['achalasia'] @entity384 :: ('MESH:D002311', 'Disease') :: ['pneumatic dilation'] @entity354 :: ('MESH:D005764', 'Disease') :: ['reflux esophagitis'] @entity3257 :: ('MESH:C580335', 'Disease') :: ['HM', 'non-HM group']
@entity1318 :: (MESH:D004931,Disease) :: ['Achalasia']
