INTRODUCTION: Per-oral endoscopic myotomy (POEM) is an emerging treatment for @entity1318 . @entity384 , botulinum toxin injection, and previous myotomy increase the difficulty of subsequent Heller myotomy, but their impact on POEM remains unknown. The purpose of this study was to compare @entity1 who had undergone prior treatment for their @entity1318 to those undergoing POEM as an initial therapy. METHODS AND PROCEDURES: All @entity1 undergoing POEM were entered into a prospective database from August 2012 to October 2014. Data collected included demographics, @entity1282 and symptom survey scores, operative time, clips required for mucosotomy closure, perioperative complications and length of hospital stay. RESULTS: Forty-five @entity1 underwent POEM during the study period. Fifteen (30  %) had undergone previous treatment (seven Botox injection, five @entity384 and three Heller myotomy). Primary POEM @entity1 were younger than those who had had prior treatment (mean age 46      17 vs. 64      12  years, p  <  0.001), but gender, body mass index and ASA class were not significantly different. There were no conversions to Heller myotomy or perioperative complications in either group. Operative time for primary POEM was 103      27 versus 102      29  min following prior treatment (p  =  0.84). Mucosotomy closure required a median 7 (4-16) and 8 (5-16) clips, respectively (p  =  0.08). Length of stay was 1  day in each group. Median @entity1282 scores decreased from 4 (0-5) to 1 (0-4) following primary POEM and 4 (0-5) to 0 (0-4) in the prior treatment group (p  =  0.45) during a median follow-up of 10  months (5-17  months). All @entity1 in each group expressed satisfaction with their procedure and would undergo the procedure again given the benefit of hindsight. CONCLUSION: Per-oral endoscopic myotomy is a safe and effective treatment for @entity1318 which improves @entity1282 and disease-specific quality of life. Previous endoscopic or laparoscopic treatment of @entity1318 does not affect the performance or early outcome of POEM.

Prior treatment does not influence the performance or early outcome of per-oral endoscopic myotomy for XXXX .

@entity1318 :: ('MESH:D004931', 'Disease') :: ['achalasia'] @entity384 :: ('MESH:D002311', 'Disease') :: ['Pneumatic dilation', 'pneumatic dilation'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity1282 :: ('MESH:D003680', 'Disease') :: ['dysphagia']
@entity1318 :: (MESH:D004931,Disease) :: ['achalasia']
