Peroral endoscopic myotomy for achalasia in patients aged ≥ 65 years

Figure 1 Case illustration of endoscopic full-thickness myotomy. A: A twisting esophagus was shown before POEM; B: Submucosal injection was made to provide a cushion; C: A longitudinal mucosal incision was made as the tunnel entry; D: Submucosal tunnel creation; E: Submucosal injection to the esophageal cavity to preset the tunnel route; F-G: Endoscopic full-thickness myotomy, peri-esophageal membrane could be seen; H: The mucosal entry was closed with several clips. POEM: Peroral endoscopic myotomy.

Figure 2 Quality of life outcomes (SF-36 domain).