ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022
Changes in Distensibility Index During an Incremental POEM Myotomy.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Impact of myotomy length on per-oral endoscopic myotomy (POEM) outcomes for achalasia: a meta-analysis of randomized trials.Surgical endoscopy · 2025Pooled it
- Endoscopic Pseudo-dilation of Esophagogastric Junction During Peroral Endoscopic Myotomy: (With Video).DEN open · 2027Article
- Mechanomedicine in digestive surgery: a theranostic framework integrating mechanical diagnostics and therapeutic modulation across the perioperative continuum.Theranostics · 2026Review
- Reflux after peroral endoscopic myotomy: The dilemma and the options.World journal of gastroenterology · 2025Article
- Association of gastric myotomy length in peroral endoscopic myotomy (POEM) with gastro-esophageal junction distensibility measured by Endoluminal Functional Lumen Imaging Probe (EndoFLIP).Esophagus : official journal of the Japan Esophageal Society · 2024Article
- What role does the submucosa play in the pathophysiology and treatment of achalasia? An analysis of impedance planimetry during POEM.Surgical endoscopy · 2023Article
- Submucosal endoscopy: the present and future.Clinical endoscopy · 2023Review
- Advances in the Diagnosis and Management of Achalasia and Achalasia-Like Syndromes: Insights From HRM and FLIP.Gastro hep advances · 2023Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA longer myotomy for the treatment of achalasia is associated with worse gastroesophageal reflux disease despite palliating dysphagia. Recently, clinical outcomes have been correlated to the distensibility of the distal esophagus, which is measured intra-operatively using an endoscopic functional luminal image probe (EndoFLIP). We aimed to determine the minimum per oral endoscopic myotomy (POEM) length to allow for adequate distensibility index (DI).
methodsA 6-cm myotomy conducted in 2-cm increments during POEM was performed for patients with achalasia I and II from 2017 to 2019. The EndoFLIP was used to measure the DI intra-operatively: (1) prior to intervention, (2) following creation of the submucosal tunnel, (3) following transection of the high-pressure zone (HPZ), (4) following the distal extension, and (5) following the proximal esophageal extension.
resultsA total of 16 patients underwent POEM. Ages ranged from 21 to 78 years, 10 were male, and 13 had type II achalasia. The median DI was 2.7 (1.4-3.6) mm
conclusionsDistensibility changed with each myotomy increment and fell within the target range for most patients following a 2-4-cm myotomy. This suggests that a shorter myotomy may be appropriate for select patients, and the use of the EndoFLIP intra-operatively may allow for a tailored myotomy length.
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