Peroral Endoscopic Myotomy in Children: First Experience With a New Triangular Knife

ABSTRACTObjectives:Peroral endoscopic myotomy (POEM) is a novel treatment modality for achalasia cardia. The procedure is technically challenging and time consuming. Recently, a new triangle tip knife (TTJ) has been introduced, which is equipped with water jet facility. In the present study, we analyzed the feasibility, safety, and efficacy of POEM in children with new triangle tip knife.Methods:We retrospectively evaluated the data of children (18 years or younger) who underwent POEM using TTJ knife at our institution. All POEM procedures were performed under general anesthesia in an endoscopy suite. Technical feasibility, safety, efficacy, and procedure duration were assessed.Results:Ten children (4 boys, 6 girls) with mean age of 14.2 ± 2.74 (9–18) years, underwent POEM with TTJ knife. The subtypes of achalasia cardia were type I (4), type II (5), and type III (1). Two children had prior treatment with pneumatic balloon dilatation. POEM was performed via anterior route in majority of children (70%). Mean operating time was 47.6 ± 19.74 (30–98) minutes with no significant difference between anterior and posterior approaches to POEM (48.57 ± 24.01 vs 45.3 ± 3.51; P 

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