Evidence map›Paper›PMID 41359117›Full record

SynthesisIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2026

Short versus standard esophageal myotomy during peroral endoscopic myotomy for achalasia: A systematic review and meta-analysis of randomized controlled trials.

Zaheer Nabi, Jahnvi Dhar, Jayanta Samanta, Pradev Inavolu, Raghavender Puri, D Nageshwar Reddy

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

6 authors.

Zaheer NabiAsian Institute of Gastroenterology, Hyderabad, 500 082, India. zaheernabi1978@gmail.com.ORCID http://orcid.org/0000-0003-2713-4781
Jahnvi DharDepartment of Gastroenterology and Hepatology, Punjab Institute of Liver and Biliary Sciences, Mohali, 160 062, India.
Jayanta SamantaDepartment of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Pradev InavoluAsian Institute of Gastroenterology, Hyderabad, 500 082, India.
Raghavender PuriDr. D. Y., Patil Medical College and Research Institute, Pune, 411 018, India.
D Nageshwar ReddyAsian Institute of Gastroenterology, Hyderabad, 500 082, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsPeroral endoscopic myotomy (POEM) is an established treatment for achalasia. Conventionally, esophageal myotomy of 6-10 cm length is performed, although its necessity in type-I and type-II achalasia remains debatable. Recent studies suggest that a shorter myotomy may offer similar efficacy with potential advantages. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing short vs. standard (long) esophageal myotomy during POEM in patients with type-I and type-II achalasia.

methodsThis review was conducted in accordance with PRISMA 2020 guidelines and registered with PROSPERO (CRD42024611252). A systematic search of PubMed, Embase and Scopus was performed to identify RCTs comparing short and long esophageal myotomy during POEM. The primary outcome was clinical success at ≥ 1 year (Eckardt score ≤ 3). Secondary outcomes included procedure time, adverse events, post-POEM integrated relaxation pressure (IRP), barium column height and gastroesophageal reflux disease (GERD). Risk of bias was assessed using the Cochrane RoB 2.0 tool and the certainty of evidence was evaluated using the GRADE framework.

resultsFour RCTs including 419 patients (short, n = 206; long, n = 213) were analyzed. Clinical success at one year was comparable between the two groups (OR 2.17; 95% CI = 0.76-6.23; p = 0.15; I2 = 12%). Procedure time was significantly shorter with short myotomy (MD - 17.69 min; p < 0.001). Rates of adverse events and physiological outcomes (IRP, barium retention) were similar. While overall GERD rates were comparable, esophageal acid exposure was significantly lower in the short myotomy group (OR 0.69; p = 0.04).

conclusionShort esophageal myotomy is non-inferior to long myotomy in clinical efficacy with the added benefit of shorter procedure time and potentially reduced acid exposure. These findings support the use of short myotomy as a safe and efficient alternative in type-I and type-II achalasia.

Indexed as

Esophageal AchalasiaEsophagoscopyEsophagusMyotomyNatural Orifice Endoscopic SurgeryRandomized Controlled Trials as TopicHumansTime FactorsTreatment OutcomeAchalasiaEndoscopy, GastrointestinalMeta-analysisMyotomyRandomized controlled trials

Identifiers

PMID41359117

What OpenQuestion holds

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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.