• At 5 years, 87.3% of POEM and 90.1% of LHD patients had an Eckardt score ≤3.
• POEM patients had a higher need for PPIs (45.6% vs 24.6%) and increased rates of esophagitis (34% vs 10.4%).

Surgeons should consider the higher GERD incidence with POEM when selecting treatment.

• Symptomatic recurrence at 5 years was low in both groups: 9 in POEM, 12 in LHD.