{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:10Z","timestamp":1787004850940,"version":"build-2736575974"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background\u2002Peroral endoscopic myotomy (POEM) is considered a primary treatment modality for achalasia. It can be performed using either the anterior or posterior approach. A previous randomized clinical trial (RCT) showed that the posterior approach was noninferior to the anterior approach at 1 year post-POEM in terms of clinical success, rate of adverse event, and risk of gastroesophageal reflux disease (GERD). The aim of this post-RCT study was to compare outcomes at \u2265\u200a2 years post-POEM.<\/jats:p>\n                  <jats:p>Methods\u2002Patients who previously completed the 1-year follow-up were contacted and their Eckardt, dysphagia, and GERD questionnaire (GERDQ) scores and frequency of proton pump inhibitor use were recorded. Clinical success was defined as an Eckardt score &lt;\u200a3.<\/jats:p>\n                  <jats:p>Results\u2002150 patients were initially randomized and 138 completed the 1-year follow-up.\u200aOf the 138, 111 (anterior group 54, posterior group 57) also completed \u2265\u200a2 years of follow-up, with an overall clinical success decrease from 89\u200a% to 82\u200a%. At \u2265\u200a2 years post-POEM, clinical success was achieved in 46\/54 (85\u200a%) and 45\/57 (79\u200a%) in the anterior and posterior groups, respectively (P\u200a=\u200a0.43). A similar decrease in clinical success was noted in both groups at \u2265\u200a2 years (anterior: 90\u200a% to 85\u200a%; posterior 89\u200a% to 79\u200a%; P\u200a=\u200a0.47). GERDQ score was 6 (interquartile range 6\u200a\u2013\u200a8; P\u200a=\u200a0.08) in both treatment groups.<\/jats:p>\n                  <jats:p>Conclusions\u2002The anterior and posterior POEM techniques remained equally effective at 2 years and decreases in efficacy were similar between the two approaches over time. GERD outcomes were also similar in both groups during medium-term follow-up.<\/jats:p>","DOI":"10.1055\/a-1204-4242","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T19:24:08Z","timestamp":1599593048000},"page":"462-468","source":"Crossref","is-referenced-by-count":38,"title":["Outcomes of anterior versus posterior peroral endoscopic myotomy 2 years post-procedure: prospective follow-up results from a randomized clinical trial"],"prefix":"10.1055","volume":"53","author":[{"given":"Yervant","family":"Ichkhanian","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jad P.","family":"Abimansour","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Pioche","sequence":"additional","affiliation":[{"name":"Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kia","family":"Vosoughi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Eleftheriadis","sequence":"additional","affiliation":[{"name":"Endoscopy Department, Gastroenterology Unit, Metropolitan Hospital Athens, Athens, Greece"},{"name":"Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip Wai Yan","family":"Chiu","sequence":"additional","affiliation":[{"name":"Division of Upper GI and Metabolic Surgery, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitomi","family":"Minami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Nagazaki University Hospital, Nagazaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumi","family":"Ogihara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Nagazaki University Hospital, Nagazaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omid","family":"Sanaei","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manol","family":"Jovani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouen A.","family":"Khashab","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,7,21]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1053\/j.gastro.2017.10.001","article-title":"Clinical practice update: the use of per-oral endoscopic myotomy in achalasia: expert review and best practice advice from the AGA Institute","volume":"153","author":"P J Kahrilas","year":"2017","journal-title":"Gastroenterology"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doy071","article-title":"The 2018 ISDE achalasia guidelines","volume":"31","author":"G Zaninotto","year":"2018","journal-title":"Dis Esophagus"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.gie.2019.04.231","article-title":"ASGE guideline on the management of achalasia","volume":"91","author":"M A Khashab","year":"2020","journal-title":"Gastrointest Endosc"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMoa1905380","article-title":"Endoscopic or surgical myotomy in patients with idiopathic achalasia","volume":"381","author":"Y B Werner","year":"2019","journal-title":"N Engl J Med"},{"key":"ref5","first-page":"107","article-title":"Anterior versus posterior myotomy during poem for the treatment of achalasia: systematic review and meta-analysis of randomized clinical trials","volume":"28","author":"E Rodriguez de Santiago","year":"2019","journal-title":"J Gastrointestin Liver Dis"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1055\/a-1090-0788","article-title":"Anterior versus posterior approach in peroral endoscopic myotomy (POEM): a systematic review and meta-analysis","volume":"52","author":"B P Mohan","year":"2020","journal-title":"Endoscopy"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.gie.2019.07.034","article-title":"Peroral endoscopic myotomy: anterior versus posterior approach: a randomized single-blinded clinical trial","volume":"91","author":"M A Khashab","year":"2020","journal-title":"Gastrointest Endosc"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1111\/j.1365-2036.2009.04142.x","article-title":"Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care","volume":"30","author":"R Jones","year":"2009","journal-title":"Aliment Pharmacol Ther"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"E190","DOI":"10.1055\/s-0043-121877","article-title":"Outcomes of anterior myotomy versus posterior myotomy during POEM: a randomized pilot study","volume":"6","author":"M Ramchandani","year":"2018","journal-title":"Endosc Int Open"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.gie.2018.03.009","article-title":"Efficacy of anterior versus posterior per-oral endoscopic myotomy for treating achalasia: a randomized, prospective study","volume":"88","author":"Y Tan","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1055\/s-0043-112490","article-title":"Will reflux kill POEM?","volume":"49","author":"T R\u00f6sch","year":"2017","journal-title":"Endoscopy"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.1136\/gutjnl-2019-318950","article-title":"Case of early Barrett cancer following peroral endoscopic myotomy","volume":"68","author":"Y Ichkhanian","year":"2019","journal-title":"Gut"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1136\/gutjnl-2014-308649","article-title":"Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years","volume":"65","author":"Y B Werner","year":"2016","journal-title":"Gut"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"e13287","DOI":"10.1111\/nmo.13287","article-title":"Evaluating the reliability and construct validity of the Eckardt Symptom Score as a measure of achalasia severity","volume":"30","author":"T H Taft","year":"2018","journal-title":"Neurogastroenterol Motil"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1055\/s-0043-105485","article-title":"Gastroesophageal reflux after peroral endoscopic myotomy: a multicenter case\u2013control study","volume":"49","author":"V Kumbhari","year":"2017","journal-title":"Endoscopy"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1204-4242.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T05:43:55Z","timestamp":1660110235000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1204-4242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,22]]},"references-count":15,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2021,4,22]]},"published-print":{"date-parts":[[2021,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1204-4242","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,6,22]]},"published":{"date-parts":[[2020,6,22]]}}}