Endoscopic ultrasound-measured muscular thickness of the lower esophageal sphincter and long-term prognosis after peroral endoscopic myotomy for achalasia

Table 1 Comparison of characteristics between patients with non-thickened and thickened lower esophageal muscularis propria

	Thickness of LEMP		P value
	< 3 mm (n = 19)	≥ 3 mm (n = 63)
Age (yr)	40.4 ± 15.2	48.4 ± 14.4	0.04
Sex (male/female)	6:13	26:37	0.448
Disease duration (mo)	37.79 ± 35.52	126.63 ± 138.49	< 0.001
History of endoscopic surgery (+/-)	1:18	5:58	0.619
Dilation grade (I/II/III)	6:4:1 (11)	15:20:7 (42)	0.667
Preoperative Eckardt score	6.53 ± 2.04	6.68 ± 1.90	0.758

LEMP: Lower esophageal muscularis propria.

Table 2 Comparison of characteristics in patients with different outcomes after peroral endoscopic myotomy

	Not effective (n = 5)	Clinical success/effective (n = 55)		P value
		No relapse (n = 48)	Relapse (n = 7)
Age (yr)	33.8 ± 11.97	48.02 ± 14.73	34.00 ± 13.05	0.021a
Sex (male/female)	3:2	16:32	4:3	0.280
Disease duration (mo)	82.8 ± 60.36	117.29 ± 131.41	35.57 ± 30.42	0.001a
Preoperative Eckardt score	6.60 ± 2.40	6.65 ± 1.74	7.57 ± 2.23	0.209a
Verification of myotomy by EUS (Yes/No)1	3:2	39:11	6:1	0.539
LEMP (thickened/ non-thickened)	4:1	39:9	5:2	0.832

¹Based on procedure number.

^aP < 0.05, between relapse and no relapse. LEMP: Lower esophageal muscularis propria; POEM: Peroral endoscopic myotomy; EUS: Endoscopic ultrasound.

Table 3 Risk factor analysis for recurrence using the Cox proportional hazards model

Variable	Univariate		Multivariate
	Hazard ratio (95%CI)	P value	Hazard ratio (95%CI)	P value
Age	0.943 (0.893-0.995)	0.033	0.920 (0.865-0.979)	0.008
Male sex	2.829 (0.629-12.712)	0.175	7.173 (1.277-40.286)	0.025
Disease duration	0.984 (0.963-1.006)	0.144	NA	0.402
Preoperative Eckardt score	1.296 (0.855-1.965)	0.222	-	-
LEMP ≥ 3 mm	0.606 (0.117-3.128)	0.550	-	-

CI: Confidence interval; LEMP: Lower esophageal muscularis propria; NA: Not assessed; -: Not included for analysis; CI: Confidence interval.