Abstract
<jats:p>The relevance of esophageal achalasia is determined by its increasing prevalence, the incomplete understanding of its etiopathogenetic mechanisms, the risk of malignant transformation, and the challenges associated with managing recurrent forms. This condition is of particular clinical importance due to its predominance among individuals of working age and its substantial negative impact on quality of life. Objective. To assess the dynamics of functional relationships between the severity of esophageal dysfunction and quality of life in patients with stage II–III achalasia before and after modified peroral endoscopic myotomy (POEM) using regression analysis. Participants and Methods. Between 2019 and 2023, 32 patients with stage II–III achalasia (16 men and 16 women; mean age 47.72±2.88 years) underwent modified peroral endoscopic myotomy. Diagnosis was based on clinical presentation, contrast radiography of the esophagus, and endoscopic examination. Treatment efficacy was evaluated using the Eckardt symptom score and the SF-36 quality of life questionnaire before surgery and at 3 months postoperatively. Results. Modified peroral endoscopic myotomy demonstrated high clinical efficacy and safety. Three months after surgery, the total Eckardt score decreased by 90.48% (p<0.05), with a significant reduction in dysphagia, regurgitation, retrosternal pain, and weight loss. Prior to treatment, a strong negative correlation was observed between the total Eckardt score and both physical and mental components of quality of life assessed by SF-36, which was adequately described by polynomial regression models (R up to −0.93; p<0.001). Changes in the degree of coupling between the severity of clinical symptoms of esophageal dysfunction and quality of life dynamics three months after surgical intervention for esophageal achalasia (the presence of a strong and statistically significant functional relationship between achalasia severity and both physical and mental health according to the SF-36 questionnaire before treatment, and the absence of interdependence between these indicators after modified peroral endoscopic myotomy) indicate a reliable dissociation of the pathogenetic aspects of the associative relationship between clinical symptom severity and subjective deterioration of quality of life in patients with esophageal achalasia. Three months after peroral endoscopic myotomy, these relationships lost statistical significance, indicating normalization of quality of life regardless of residual symptoms. The mean length of hospital stay was 3.22±0.29 days. Conclusion. Modified peroral endoscopic myotomy is an effective and minimally invasive treatment for stage II–III esophageal achalasia, providing rapid and statistically significant improvement in clinical symptoms and quality of life, as well as reduced hospitalization time compared with conventional surgical approaches.</jats:p>