{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:47:15Z","timestamp":1790891235900,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,1,28]],"date-time":"2019-01-28T00:00:00Z","timestamp":1548633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The introduction of high-resolution manometry and the Chicago classification has made it possible to diagnose achalasia and predict treatment response accurately. The aim of this study was to compare the effect of the different treatments available on symptomatic outcomes across all achalasia subtypes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The study was conducted according to PRISMA and MOOSE guidelines. A literature search of PubMed and MEDLINE databases was undertaken to identify all relevant articles reporting clinical outcomes of patients with achalasia after botulinum toxin injection, pneumatic dilatation, laparoscopic Heller myotomy (LHM) and peroral endoscopic myotomy (POEM) based on manometric subtypes. Patients were grouped according to the Chicago classification and the success rate in treating symptoms was measured as the primary endpoint.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty studies (1575 patients) were selected, and data on botulinum toxin, pneumatic dilatation, LHM and POEM were extracted. Success rates for LHM in type I, II and III achalasia were 81, 92 and 71 per cent respectively. Those for POEM were 95, 97 and 93 per cent respectively. POEM was more likely to be successful than LHM for both type I (odds ratio (OR) 2\u00b797, 95 per cent c.i. 1\u00b709 to 8\u00b703; P = 0\u00b7032) and type III (OR 3\u00b750, 1\u00b739 to 8\u00b777; P = 0\u00b7007) achalasia. The likelihood of success of POEM and LHM for type II achalasia was similar.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Pneumatic dilatation had a lower but still acceptable success rate compared with POEM or LHM in patients with type II achalasia. POEM is an excellent treatment modality for type I and type III achalasia, although it did not show any superiority over LHM for type II achalasia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.11049","type":"journal-article","created":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T03:46:59Z","timestamp":1548733619000},"page":"332-341","source":"Crossref","is-referenced-by-count":118,"title":["Meta-analysis of clinical outcome after treatment for achalasia based on manometric subtypes"],"prefix":"10.1093","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1844-377X","authenticated-orcid":false,"given":"C","family":"Andolfi","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P M","family":"Fisichella","sequence":"additional","affiliation":[{"name":"Department of Surgery, Brigham and Women's Hospital and Boston VA Healthcare System, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,1,28]]},"reference":[{"key":"2021012711233831300_bjs11049-bib-0001","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S0140-6736(13)60651-0","article-title":"Achalasia","volume":"383","author":"Boeckxstaens","year":"2014","journal-title":"Lancet"},{"key":"2021012711233831300_bjs11049-bib-0002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.gtc.2012.11.001","article-title":"High-resolution manometry and esophageal pressure topography: filling the gaps of convention manometry","volume":"42","author":"Carlson","year":"2013","journal-title":"Gastroenterol Clin North Am"},{"key":"2021012711233831300_bjs11049-bib-0003","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1053\/j.gastro.2008.07.022","article-title":"Achalasia: a new clinically relevant classification by high-resolution manometry","volume":"135","author":"Pandolfino","year":"2008","journal-title":"Gastroenterology"},{"key":"2021012711233831300_bjs11049-bib-0004","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/nmo.12477","article-title":"International High Resolution Manometry Working Group. The Chicago Classification of esophageal motility disorders, v3.0","volume":"27","author":"Kahrilas","year":"2015","journal-title":"Neurogastroenterol Motil"},{"key":"2021012711233831300_bjs11049-bib-0005","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"2021012711233831300_bjs11049-bib-0006","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting. 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Therapeutic outcome of achalasia based on high-resolution manometry: a Korean multicenter study","author":"Lee","year":"2017","journal-title":"Am J Ther"},{"key":"2021012711233831300_bjs11049-bib-0010","doi-asserted-by":"crossref","first-page":"48","DOI":"10.5056\/jnm.2011.17.1.48","article-title":"Achalasia cardia subtyping by high-resolution manometry predicts the therapeutic outcome of pneumatic balloon dilatation","volume":"17","author":"Pratap","year":"2011","journal-title":"J Neurogastroenterol Motil"},{"key":"2021012711233831300_bjs11049-bib-0011","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1053\/j.gastro.2012.12.027","article-title":"Outcomes of treatment for achalasia depend on manometric subtype","volume":"144","author":"Rohof","year":"2013","journal-title":"Gastroenterology"},{"key":"2021012711233831300_bjs11049-bib-0012","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1159\/000343902","article-title":"Predictive factors associated with the success of 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