Per-oral endoscopic myotomy in achalasia: Which way to go—anterior or posterior?

We read with great interest the article by Tan et al1 wherein the authors have compared the efficacy and safety of per-oral endoscopic myotomy (POEM) by an anterior versus a posterior approach. The authors concluded that POEM is equally safe and effective when performed by an anterior or a posterior approach. In addition, the incidence of gastroesophageal reflux disease (GERD) was equal in both groups (anterior, 26.7%; posterior, 33.3%).

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