{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:06:22Z","timestamp":1788397582184,"version":"build-2803163510"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The aim of this study is to compare outcomes of POEM for achalasia between those with (PI) or without (NPI) previous disease intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Single-center retrospective study of consecutive achalasia patients with or without\u2009\u2265\u20091 prior intervention with pneumatic dilation (PD), Heller myotomy (LHM), and\/or Botox injection (BTI) who underwent POEM and had\u2009\u2265\u20096-month follow-up. Baseline testing: Eckardt Score (ES), high-resolution manometry (HRM), and functional lumen imaging probe (FLIP) of the esophagogastric junction (EGJ) at 50-mL distention. Between 6 and 12\u00a0months after POEM, patients were questioned about daily PPI use and HRM, ES, FLIP, EGD, and pH testing off anti-secretory medications were repeated when possible. Clinical response was defined as follows: ES\u2009\u2265\u20093, EGJ-DI\u2009&gt;\u20092.8\u00a0mm\n                      <jats:sup>2<\/jats:sup>\n                      \/mmHg, and integrated relaxation pressure (IRP)\u2009&lt;\u200915\u00a0mmHg. GERD was defined as acid exposure time (AET)\u2009&gt;\u20096%. Outcomes were compared between the PI and NPI groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      471 patients (mean: 55\u2009\u00b1\u200919 yrs; 60% M) with type 1 (17%), 2 (72%) or 3 (11%) achalasia with no prior (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009325) or a prior (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009126) intervention were identified. The PI group was older (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), had a lower baseline ES (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), lower IRP (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), higher EGJ-DI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), and a longer POEM procedure time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) compared to the NPI group. Mean overall clinical response by ES (95.3%), IRP (86.7%), and EGJ-DI (86.2%), and daily PPI use (30%), esophagitis (65%), and AET\u2009&gt;\u20096% (49%) were similar between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Achalasia patients with previous LES-directed interventions undergoing POEM are older, have lower ES, lower LES pressure\/tone, and require longer POEM times compared to those without previous interventions. Prior intervention does not impact the frequency of clinical response, daily PPI use, esophagitis or post-POEM GERD (ClinicalTrials.gov NCT02770859).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-025-12258-3","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T14:52:59Z","timestamp":1759762379000},"page":"174-181","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of prior endoscopic or surgical interventions on clinical outcomes after peroral endoscopic myotomy for achalasia"],"prefix":"10.1007","volume":"40","clinical-trial-number":[{"clinical-trial-number":"nct02770859","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3835-4464","authenticated-orcid":false,"given":"John","family":"DeWitt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Stainko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Perkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rosenheck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Al-Haddad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"12258_CR1","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.14309\/ajg.0000000000000731","volume":"115","author":"MF Vaezi","year":"2020","unstructured":"Vaezi MF, Pandolfino JE, Yadlapati RH et al (2020) ACG clinical guidelines: diagnosis and management of achalasia. 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