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Background and Aim: Peroral endoscopic myotomy(POEM)has been developed to treat esophageal achalasia as a novel less invasive modality.We aimed to compare the efficacy and safety of conventional versus Hybrid knife methods during POEM procedure.Method: Between June 2012 and July 2014,31 patients underwent POEM using Hybrid knife in our department(HK group)(Figure 1),and 36 patients underwent POEM using conventional method(injection needle and triangular tip knife,TT group)(Figure 2).