{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T18:36:29Z","timestamp":1778610989788,"version":"3.51.4"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Achalasia is a condition related to failure of relaxation of the lower esophageal sphincter (LES). Treatment is based on reducing LES pressure. Although treatment is traditionally surgical, poor candidates for this modality may be treated with peroral endoscopic myotomy (POEM). However, POEM is associated with a relatively high incidence of gastroesophageal reflux disease (GERD). For cases refractory to proton pump inhibitors (PPIs), transoral incisionless fundoplication (TIF) is one of the endoscopic therapies proposed.<\/jats:p><jats:p>This was a pilot single-center prospective cohort study including 10 patients with post-POEM GERD refractory to clinical management who underwent endoscopic treatment with the TIF procedure between February and November 2021. We included patients \u2265 18 years old who developed GERD after POEM.<\/jats:p><jats:p>Technical success was achieved in all 10 cases treated with TIF. In 6- and 12-month follow-up, seven patients (70%) reduced PPI use. Two patients (20%) had no esophagitis initially, increasing to five (55%) at 6 months and four (44%) at 12 months. Symptom evaluation and GERD-HRQL questionnaire showed a significant score reduction at 6 months and a downward trend at 12 months. Mean Eckardt score showed a decreasing trend, although mean dysphagia score showed a slight tendency to increase in 1 year. The procedure was considered safe, with no adverse events.<\/jats:p><jats:p>Use of TIF seems to be a feasible alternative for treating GERD after POEM, improving both clinical and endoscopic parameters and pHmetry in a considerable percentage of cases.<\/jats:p>","DOI":"10.1055\/a-2681-2538","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T22:54:56Z","timestamp":1754952896000},"source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Transoral incisionless fundoplication for patients with gastroesophageal reflux disease after peroral endoscopic myotomy: Prospective cohort"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8023-3722","authenticated-orcid":false,"given":"Eduardo Guimar\u00e3es Hourneaux","family":"de Moura","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Hospital das Clinicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9230-0953","authenticated-orcid":false,"given":"Matheus Ferreira","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Hospital das Clinicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5132-0309","authenticated-orcid":false,"given":"Victor","family":"Lira de Oliveira","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Hospital das Clinicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2641-4952","authenticated-orcid":false,"given":"Mateus Bond","family":"Boghossian","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Hospital das Clinicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Afonso","family":"Miranda Neto","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Hospital das Clinicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo Turiani Hourneaux","family":"de Moura","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Hospital das Clinicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9 Orsini","family":"Ardengh","sequence":"additional","affiliation":[{"name":"Surgery, Faculdade de Ci\u00eancias M\u00e9dicas da Santa Casa de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ary","family":"Nasi","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Hospital das Clinicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Chang","sequence":"additional","affiliation":[{"name":"Medicine, University of California Irvine, Irvine, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4828-9320","authenticated-orcid":false,"given":"Mateus Pereira","family":"Funari","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Hospital das Clinicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"},{"name":"USP, Universidade de S\u00e3o Paulo Faculdade de Medicina, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.gie.2022.03.004","article-title":"Evolution and evidence-based adaptations in techniques for peroral endoscopic myotomy for achalasia","volume":"96","author":"A Hasan","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1016\/j.gie.2017.10.022","article-title":"GERD after per-oral endoscopic myotomy as compared with Heller\u2019s myotomy with fundoplication: a systematic review with meta-analysis","volume":"87","author":"A Repici","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1097\/SLA.0000000000005677","article-title":"Outcomes of Heller myotomy for esophageal achalasia: Lessons from a 48-year prospective experience with 4 different techniques","volume":"278","author":"V Tassi","year":"2023","journal-title":"Ann Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"E1673","DOI":"10.1055\/a-1261-3417","article-title":"Peroral endoscopic myotomy (POEM) is more cost-effective than laparoscopic Heller myotomy in the short term for achalasia: economic evaluation from a randomized controlled trial","volume":"8","author":"TM Conte","year":"2020","journal-title":"Endosc Int Open"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1007\/s00268-022-06477-1","article-title":"Peroral endoscopic myotomy for achalasia","volume":"46","author":"MB Ujiki","year":"2022","journal-title":"World J Surg"},{"key":"ref6","article-title":"Gastroesophageal reflux waning over time in endoscopic versus surgical myotomy for the treatment of achalasia: A systematic review and meta-analysis","volume":"14","author":"AS-T 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Tyberg","year":"2018","journal-title":"Endosc Int Open"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1055\/a-1446-8953","article-title":"Is transoral incisionless fundoplication (TIF) an answer to post-peroral endoscopic myotomy gastroesophageal reflux? 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