ArticleSurgical endoscopy2020
Per-oral endoscopic myotomy (POEM) for a sigmoid type of achalasia: short-term outcomes and changes in the esophageal angle.
Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and Safety of Peroral Endoscopic Myotomy for Sigmoid-Type Achalasia: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Symptom duration is associated with esophageal remodeling in achalasia treated by peroral endoscopic myotomy.Scientific reports · 2026Observational
- Multiple submucosal tunneling endoscopic myotomies to address angulation in advanced sigmoid-type achalasia.Gastroenterology report · 2026Article
- Long-term outcome of peroral endoscopic myotomy for sigmoid-type achalasia: S1 vs S2 subtypes.Surgical endoscopy · 2026Article
- Esophageal morphology does not predict post-operative outcomes after peroral endoscopic myotomy.Surgical endoscopy · 2025Article
- Esophageal tortuosity in achalasia: increased length-to-height ratio predicts inferior symptom relief and esophageal emptying following myotomy.Surgical endoscopy · 2025Article
- Novel scale for evaluating the therapeutic efficacy of per-oral endoscopic myotomy in achalasia.Journal of gastroenterology · 2024Article
- Role of Peroral Endoscopic Myotomy in Advanced Achalasia Cardia With Sigmoid and/or Megaesophagus: A Systematic Review and Metanalysis.Journal of neurogastroenterology and motility · 2022Article
- The Modern Age of POEM: the Past, Present and Future of Per-Oral Endoscopic Myotomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Review
- Outcomes of Per-oral Endoscopic Myotomy in Sigmoid and Advanced Sigmoid Achalasia.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Quantification of Esophageal Angulation in Sigmoid Achalasia: Are We There Yet?Journal of neurogastroenterology and motility · 2020Article
- Peroral Endoscopic Myotomy as a Novel Treatment for Achalasia: Patient Selection and Perspectives.Clinical and experimental gastroenterology · 2020Review
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Authors and funding
10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPer-oral endoscopic myotomy (POEM) is an endoscopic procedure whereby the esophageal muscle is incised in order to lower the lower esophageal sphincter (LES) pressure. Since the time it was first performed in 2008 and subsequently reported on in 2010 by Inoue et al., POEM has been shown to be safe and effective for straight type of achalasia. On the other hand, the efficacy of POEM had been controversial for patients with achalasia of the sigmoid type, in which a high LES pressure is accompanied by morphological changes, including dilation, acute angulation, and rotation. The aim of this study is to evaluate the safety and efficacy of POEM in patients with sigmoid type of achalasia.
methodsBetween May 2015 and December 2017, 16 patients with a sigmoid type of achalasia underwent POEM in our institute. The POEM procedure was the same as that for the straight type of achalasia. The double-scope technique was used to check the distal end of the submucosal tunnel from the gastric side. The primary endpoint was improvement of Eckardt score at 2 months after POEM. The secondary endpoints comprised operating time, change in the esophageal angulation, and adverse events.
resultsAll patients underwent POEM without severe adverse events. The respective parameters before and after POEM significantly differed in terms of mean (SD) Eckardt score [4.9 (2.0) vs. 0.4 (0.6), p < 0.01], LES pressure [19.4 (10.2) vs. 9.2 (6.4), p < 0.01], and integrated relaxation pressure [17.6 (9.2) vs. 7.9 (5.5), p < 0.01]. The average operation time was 94.7 ± 31.4 min. The average esophageal angulation was 88.4° ± 23.1° before POEM and 109.5° ± 16.7° after POEM (p < 0.01). Four patients had postoperative complications that were treated conservatively.
conclusionsPOEM can improve both LES pressure and esophageal angulation in patients with sigmoid achalasia.
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