Evidence map›Paper›PMID 39576447›Full record

ArticleEsophagus : official journal of the Japan Esophageal Society2025

An "esophageal rosette" sign is useful for predicting favorable outcomes in peroral endoscopic myotomy for esophageal achalasia.

Kazutoshi Higuchi, Osamu Goto, Noriyuki Kawami, Eri Momma, Yoshimasa Hoshikawa, Shintaro Hoshino, Masahiro Niikawa, Shun Nakagome, Tsugumi Habu, Keiichiro Yoshikata and 8 more

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Article in Esophagus : official journal of the Japan Esophageal Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

18 authors.

Kazutoshi HiguchiDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Osamu GotoDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Noriyuki KawamiDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Eri MommaDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Yoshimasa HoshikawaDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Shintaro HoshinoDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Masahiro NiikawaDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Shun NakagomeDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Tsugumi HabuDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Keiichiro YoshikataDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Yumiko IshikawaDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Eriko KoizumiDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Kumiko KiritaDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Hiroto NodaDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Takeshi OndaDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Jun OmoriDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Naohiko AkimotoDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Katsuhiko IwakiriDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan. k-iwa@nms.ac.jp.ORCID 0000-0002-5558-6104

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAn "esophageal rosette" (ER) sign is one of the endoscopic findings in primary esophageal achalasia. We investigated whether ER was associated with the therapeutic efficacy of peroral endoscopic myotomy (POEM).

methodsThe clinical characteristics and short-term outcomes of POEM were retrospectively evaluated in 69 patients who underwent the procedure for esophageal achalasia. The patients were divided into two groups according to the presence of an ER sign (ER and non-ER groups). Clinical success was defined as the post-POEM Eckardt score of three or less.

resultsOn preoperative endoscopy, 55 (79.7%) patients exhibited ER. The patients in the ER group had a longer disease duration than those in the non-ER group (7.4 vs. 2.7 years, P = 0.0011), although the Eckardt scores before POEM were similar between the two groups. No differences were observed in POEM outcomes between the two groups, including procedure time, length of myotomy, hospital stay, and adverse events. The clinical success of POEM was more frequent in the ER group than in the non-ER group (96.2% vs. 78.6%, P = 0.027). Although the changes in the total Eckardt score and integrated relaxation pressure did not differ between the two groups, dysphagia in the Eckardt score significantly improved in the ER group.

conclusionsThe data suggest that POEM for esophageal achalasia with ER could lead to favorable therapeutic outcomes, particularly dysphagia. The presence of ER may help determine the optimal treatment for esophageal achalasia.

Indexed as

Esophageal AchalasiaEsophagoscopyMyotomyAdultAgedEsophagusFemaleHumansLength of StayMaleMiddle AgedNatural Orifice Endoscopic SurgeryOperative TimeRetrospective StudiesTreatment OutcomeEsophageal achalasiaEsophageal rosettePeroral endoscopic myotomy

Identifiers

PMID39576447

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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.