Evidence map›Paper›PMID 31993815›Full record

ArticleSurgical endoscopy2020

Peroral endoscopic myotomy alone is effective for esophageal motility disorders and esophageal epiphrenic diverticulum: a retrospective single-center study.

Masato Kinoshita, Shinwa Tanaka, Fumiaki Kawara, Hiroya Sakaguchi, Hirofumi Abe, Ryusuke Ariyoshi, Takashi Toyonaga, Yuzo Kodama

Abstract read
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In one paragraph

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 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
7.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 34 citations in OpenAlex.

  1. Review
  2. Article
  3. Minimally invasive surgical management of mid- to distal esophageal diverticula: a large single-center review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026
    Article
  4. Article
  5. Review
  6. Review
  7. Taming type III achalasia and coexisting diverticula with complex surgical history with peroral endoscopic myotomy.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
    Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Esophageal motility disorders missed during endoscopy.Esophagus : official journal of the Japan Esophageal Society · 2022
    Article
  16. Successful D-POEM after failed surgical myotomy and diverticulectomy.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2022
    Article
  17. Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Masato KinoshitaDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Chu-o-ku, Kusunoki-cho, Kobe, Hyogo, 650-0017, Japan.
Shinwa TanakaDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Chu-o-ku, Kusunoki-cho, Kobe, Hyogo, 650-0017, Japan. tanakas@med.kobe-u.ac.jp.
Fumiaki KawaraDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Chu-o-ku, Kusunoki-cho, Kobe, Hyogo, 650-0017, Japan.
Hiroya SakaguchiDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Chu-o-ku, Kusunoki-cho, Kobe, Hyogo, 650-0017, Japan.
Hirofumi AbeDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Chu-o-ku, Kusunoki-cho, Kobe, Hyogo, 650-0017, Japan.
Ryusuke AriyoshiDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Chu-o-ku, Kusunoki-cho, Kobe, Hyogo, 650-0017, Japan.
Takashi ToyonagaDepartment of Endoscopy, Kobe University Hospital, Kobe, Japan.
Yuzo KodamaDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Chu-o-ku, Kusunoki-cho, Kobe, Hyogo, 650-0017, Japan.
Kobe University · JPKobe University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEsophageal epiphrenic diverticulum (ED) is associated with esophageal motility disorder (EMD). If a diverticulum associated with EMD is enlarging with worsening symptoms, surgical intervention, including laparoscopic epiphrenic diverticulectomy with myotomy and fundoplication, is indicated. However, some studies suggest that myotomy alone, with less adverse events, is sufficient to improve symptoms. Additionally, peroral endoscopic myotomy (POEM) is considered effective and safe for EMD. Since theoretically, POEM is endoscopic Heller myotomy, POEM without diverticulectomy is considered a less invasive, promising treatment option for EMD and ED. We aimed to determine the efficacy and safety of POEM alone for ED with EMD.

methodsThis single-center study was retrospective. A total of 298 patients underwent POEM in Kobe University Hospital from April 2015 to October 2018. Of them, 14 patients had ED. Procedure-related outcomes and treatment outcomes 3 months post POEM were evaluated in these patients.

resultsThe median maximum ED diameter was 29 (range 9-90) mm; and the median POEM procedure time, 77.5 (range 41-123) min. Pneumoperitoneum, which required needle decompression, occurred in one patient, but no fatal adverse events occurred. The median Eckardt score significantly decreased from 5 [range 2-11] pre POEM to 0 [range 0-2] post POEM (P < 0.0001). The median integrated relaxation pressure significantly decreased from 22.5 [13.9-34.3] mmHg pre POEM to 10.2 [0.7-23.9] mmHg post POEM (P < 0.0001). Of 14 patients, only one patient complained of gastroesophageal reflux disease symptoms, which could be controlled with a potassium-competitive acid blocker.

conclusionsPOEM alone seemed effective and safe for patients with EMD and ED.

Indexed as

AgedAged, 80 and overDiverticulum, EsophagealEndoscopyEsophageal Motility DisordersFemaleHumansMaleMiddle AgedMyotomyNatural Orifice Endoscopic SurgeryRetrospective StudiesTreatment OutcomeAchalasiaEpiphrenic diverticularEsophageal motility disorderPeroral endoscopic myotomy

Identifiers

PMID31993815
OpenAlexW3004003842

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.