{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T23:31:44Z","timestamp":1772580704356,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Long\u2010term outcome data are limited for non\u2010achalasia esophageal motility disorders treated by peroral endoscopy myotomy (POEM) as a separate group. We investigated a subset of symptomatic patients with hypercontractile esophagus (Jackhammer esophagus).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty two patients (mean age 60.9\u00a0years; 57% female, mean Eckardt score 6.2\u00a0\u00b1\u00a02.1) treated by primary peroral myotomy for symptomatic Jackhammer esophagus 2012\u20132018 in seven European centers were retrospectively analyzed; myotomy included the lower esophageal sphincter but did not extend more than 1\u00a0cm into the cardia in contrast to POEM for achalasia. Manometry data were re\u2010reviewed by an independent expert. The main outcome was the failure rate defined by retreatment or an Eckardt score &gt;3 after at least two years following POEM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Despite 100% technical success (mean intervention time 107\u00a0\u00b1\u00a048.9\u00a0min, mean myotomy length 16.2\u00a0\u00b1\u00a03.7\u00a0cm), the 2\u2010year success rate was 64.3% in the entire group. In a subgroup analysis, POEM failure rates were significantly different between Jackhammer\u2010patients without (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a022), and with esophagogastric junction outflow obstruction (EGJOO,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a020) (13.6% % vs. 60%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.003) at a follow\u2010up of 46.5\u00a0\u00b1\u00a019.0\u00a0months. Adverse events occurred in nine cases (21.4%). 14 (33.3%) patients were retreated, two with surgical fundoplication due to reflux. Including retreatments, an improvement in symptom severity was found in 33 (78.6%) at the end of follow\u2010up (Eckardt score \u22643, mean Eckardt change 4.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). EGJOO (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01) and frequency of hypercontractile swallows (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.02) were predictors of POEM failure. The development of a pseudodiverticulum was observed in four cases within the subgroup of EGJOO.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with symptomatic Jackhammer without EGJOO benefit from POEM in long\u2010term follow\u2010up. Treatment of Jackhammer with EGJOO, however, remains challenging and probably requires full sphincter myotomy and future studies which should address the pathogenesis of this variant and alternative strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.12586","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T06:31:53Z","timestamp":1718346713000},"page":"930-940","source":"Crossref","is-referenced-by-count":3,"title":["Peroral endoscopic myotomy for hypercontractile (Jackhammer) esophagus: A retrospective multicenter series with long\u2010term follow\u2010up"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1507-4590","authenticated-orcid":false,"given":"David","family":"Albers","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Gastroenterology Elisabeth\u2010Krankenhaus Essen  Essen 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