Abstract: Objective  To analyze the risk factors associated with recurrence of achalasia (AC) treated with peroral endoscopic myotomy (POEM). Methods  The data of 81 patients diagnosed with AC and underwent POEM at Beijing Friendship Hospital from 2014 to 2019 were collected retrospectively, and multivariate Logistic regression analysis was conducted to analyze the risk factors of recurrence after POEM. Results  Postoperative recurrence occurred in 6 patients, recurrence rate was 7.41% and the medium recurrence duration was 3 years. Gender （P =0.04)and smoking （P=0.02) were related to the recurrence of AC after POEM. There was no significant difference between the groups in age, disease duration, drinking, integrated relaxation pressure (IRP), esophageal diameter and muscularis propria layer thickness. Further COX regression analysis showed that the smoking was an independent risk factor for recurrence of AC after POEM （HR=10.84，P =0.04). Conclusion  Smoking was an independent risk factor for recurrence of AC after POEM.

Key words: achalasia, peroral endoscopic myotomy, risk factors