Long-term outcomes of peroral endoscopic myotomy with simultaneous submucosal and muscle dissection (POEM-SSMD) for achalasia with severe interlayer adhesions

[1] During the short-term follow-up, the symptoms of the patient were significantly improved. [...]for patients with esophageal interlayer adhesions, the relative indications of POEM may be extended. [...]the present study aimed to further report the long-term outcomes of POEM-SSMD for achalasia with severe interlayer adhesions in a relatively larger population. According to the endoscopic morphology of esophageal lumen reported in the previous study,[3] 3 patients (14%), 2 patients (9%), 16 patients (73%), and 1 patient (5%) were Ling classification IIa, IIb, IIc, and IIIr types, respectively. [...]performing modified POEM to address this challenge is necessary.