Sling-Fiber Preservation POEM vs. Conventional POEM for Reducing Post-POEM GERD

Peroral endoscopic myotomy (POEM) is an effective, minimally invasive treatment for achalasia, offering excellent rates of symptom relief. However, a significant drawback is the high incidence of gastroesophageal reflux disease (GERD) following the procedure. One proposed technical modification, the selective preservation of the sling fibers during gastric myotomy (SFP-POEM), may reduce this risk without compromising efficacy as compared to a conventional POEM procedure, which includes myotomy of the sling fibers. In this study, adults with achalasia will be randomly assigned to receive one of the two POEM technical approaches. Researchers will monitor whether preserving sling fibers reduces the rates of reflux esophagitis (classified as Los Angeles Grade B or higher) on follow-up endoscopy. Participants will be followed for up to 1 year after the procedure.

NCT Number	NCT07178821
Lead Sponsor	University of California, Irvine Collaborators: Hoag Memorial Hospital Presbyterian, University of Ottawa, Vancouver General Hospital, Cedars-Sinai Medical Center
Conditions	Achalasia, Esophageal, GERD (Gastroesophageal Reflux Disease)
Enrollment	120 participants
Start Date	2025-12-01
Primary Completion	2027-12-01 (estimated)
Study Completion	2028-01-01 (estimated)
Updated on ClinicalTrials.gov	2025-10-22