Evidence map›Paper›PMID 32206921›Full record

SynthesisSurgical endoscopy2021

Risk factors for gastroesophageal reflux after POEM for achalasia: a systematic review and meta-analysis.

Raquel Cristina Lins Mota, Eduardo Guimarães Hourneaux de Moura, Diogo Turiani Hourneaux de Moura, Wanderlei Marques Bernardo, Eduardo Turiani Hourneaux de Moura, Vitor O Brunaldi, Paulo Sakai, Christopher C Thompson

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed
5.0field-weighted citation impact, top 4% 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

25 citing papers in PubMed, 52 citations in OpenAlex.

  1. Peroral endoscopic myotomyWorld journal of gastroenterology · 2022
    Trial
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  3. Review
  4. Article
  5. Saudi Gastroenterology Association (SGA) clinical care pathway and standards of care for peroral endoscopic myotomy (POEM) in achalasia.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026
    Article
  6. Epithelial Barrier Function and Altered Cell Signaling Pathways in the Esophageal Epithelium of Achalasia Patients.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2025
    Article
  7. Review
  8. Article
  9. Article
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  11. Article
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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 2 countries.

Raquel Cristina Lins MotaGastroenterology Department - Hospital das Clínicas da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, SP, Brazil.
Eduardo Guimarães Hourneaux de MouraGastroenterology Department - Hospital das Clínicas da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, SP, Brazil.
Diogo Turiani Hourneaux de MouraGastroenterology Department - Hospital das Clínicas da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, SP, Brazil.
Wanderlei Marques BernardoGastroenterology Department - Hospital das Clínicas da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, SP, Brazil.
Eduardo Turiani Hourneaux de MouraGastroenterology Department - Hospital das Clínicas da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, SP, Brazil.
Vitor O BrunaldiGastroenterology Department - Hospital das Clínicas da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, SP, Brazil.
Paulo SakaiGastroenterology Department - Hospital das Clínicas da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, SP, Brazil.
Christopher C ThompsonDivision of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA. cthompson@hms.harvard.edu.ORCID http://orcid.org/0000-0002-6105-5270
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRBrigham and Women's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPeroral endoscopic myotomy (POEM) demonstrated similar efficacy to surgical myotomy in the management of achalasia. However, gastroesophageal reflux disease (GERD) is common after POEM. The aim of this study is to identify factors associated with GERD after POEM.

methodAfter searching electronic databases, randomized trials and observational studies including patients with achalasia or other spastic esophageal disorders, treated by POEM, and providing GERD data were selected. GERD was evaluated by 3 methods: pH monitoring, endoscopic findings, and symptoms. For each method, an analysis was performed comparing the outcomes related to the following independent variables: full-thickness (FT) vs circular myotomy, anterior vs posterior, long myotomy vs short myotomy, naive vs previous treatment failure, previous Heller myotomy (HM) vs non-previous-HM, Type I vs II, Type I vs III, and Type II vs III.

results2869 publications were identified, and 25 studies met criteria for inclusion in the qualitative analysis. Of these, 18 were included in the meta-analysis. According to the endoscopic findings, circular and anterior myotomy demonstrated a lower trend of GERD with borderline significance (p = 0.06; p = 0.07, respectively). In the pH monitoring and symptom analyses, circular myotomy, anterior myotomy, treatment naive, and non-HM patients were associated with a lower occurrence of GERD; however, no statistically significant difference was found. When comparing achalasia subtypes, no statistical difference was found in all analyses.

conclusionThis systematic review and meta-analysis suggest that a circular anterior approach may limit post-POEM GERD and should be considered in appropriate patients.

Indexed as

Esophageal AchalasiaEsophagitis, PepticGastroesophageal RefluxHeller MyotomyHumansMaleMyotomyNatural Orifice Endoscopic SurgeryPostoperative ComplicationsRisk FactorsTreatment OutcomeAchalasiaEndoscopyGERDMyotomyPOEMSurgery

Identifiers

PMID32206921
OpenAlexW3012721335

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.