Clinical Outcomes and Safety of Partial Full-Thickness Myotomy versus Circular Muscle Myotomy in Peroral Endoscopic Myotomy for Achalasia Patients

Figure 2

(a-1) The myotomy was begun at about 2 cm distal to the mucosal entry. In partial full-thickness myotomy, not only the circular muscle layer but also the longitudinal muscle layer was cut at 2 cm above the EGJ. (a-2) Distal of full-thickness myotomy was extended to the fundus of the stomach. Incision was closed by endoscopic metallic clips. (b-1) The myotomy was begun at about 2 cm distal to the mucosal entry in partial full-thickness myotomy. In circular muscle myotomy, only circular muscle layer was resected and the longitudinal muscle layer was carefully protected. (b-2) Distal of circular muscle myotomy was extended to the fundus of the stomach. Incision was closed by endoscopic metallic clips.