{"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":1788397582462,"version":"build-2803163510"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Peroral endoscopic myotomy (POEM) is a treatment option for patients with previous surgical or endoscopic treatment. We aimed to evaluate the influence of prior treatment on perioperative and follow-up outcomes in patients undergoing POEM.<\/jats:p><jats:p>\n          Methods\u2002From August 2010 to December 2014, a total of 1384 patients with achalasia underwent POEM at our center. We retrospectively reviewed 849 patients who completed follow-up.\u200aPatients with an Eckardt score \u2265\u200a4 after POEM were considered to have a clinical failure. We compared variables between patients with and without prior treatment. We analyzed risk factors for perioperative major adverse events, and clinical re\ufb02ux and failure during follow-up.\u200a<\/jats:p><jats:p>\n          Results\u2002245 patients (28.9\u200a%) had undergone prior treatment, and 34 patients (4.0\u200a%) experienced a major adverse event associated with the POEM procedure. During a median follow-up of 23 months (range 1\u200a\u2013\u200a71), clinical reflux occurred in 203 patients (23.9\u200a%) and clinical failure was recorded for 94 patients (11.1\u200a%). Patients with prior treatment had a longer procedure duration (P\u200a=\u200a0.001) and longer hospital stay after POEM (P\u200a=\u200a0.001). Prior treatment was not an independent risk factor for major adverse events or clinical reflux (odds ratio [OR] 1.19, P\u200a=\u200a0.65; OR 1.26, P\u200a=\u200a0.19; logistic regression), but it did increase the rate of clinical failure during follow-up (hazard ratio 1.90, P\u200a=\u200a0.002; Cox regression). <\/jats:p><jats:p>\n          Conclusions\u2002POEM was performed safely with a low rate of major adverse events in patients with achalasia who had undergone prior surgical or endoscopic treatment. However, prior treatment increased the risk of clinical failure after POEM.<\/jats:p>","DOI":"10.1055\/a-0658-5783","type":"journal-article","created":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T23:23:33Z","timestamp":1538090613000},"page":"307-316","source":"Crossref","is-referenced-by-count":79,"title":["The effect of prior treatment on clinical outcomes in patients with achalasia undergoing peroral endoscopic myotomy"],"prefix":"10.1055","volume":"51","author":[{"given":"Zu-Qiang","family":"Liu","sequence":"first","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan-Lin","family":"Li","sequence":"first","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Feng","family":"Chen","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Cen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiu-Ning","family":"Wu","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Yan","family":"Cai","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Zheng","family":"Qin","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Wei","family":"Hu","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Qun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Dong","family":"Xu","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Qing","family":"Yao","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping-Hong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,9,27]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1038\/nrgastro.2015.87","article-title":"Peroral endoscopic myotomy: an evolving treatment for achalasia","volume":"12","author":"R Bechara","year":"2015","journal-title":"Nat Rev Gastroenterol 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