{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:31:50Z","timestamp":1790778710215,"version":"4.1.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Peroral endoscopic myotomy (POEM) can be performed via an anterior or posterior approach, depending on the operator\u2019s preference. Data are lacking on comparative outcomes of both approaches. <\/jats:p><jats:p>\n          Patients and methods\u2002This is a pilot randomized study comparing endoscopic anterior and posterior myotomy during POEM in patients with Achalasia cardia (AC). Patients were randomized into 2 groups (n\u200a=\u200a30 in each group); anterior myotomy group (AG) and posterior myotomy group (PG) and were followed at 1, 3 and 6 months after POEM.<\/jats:p><jats:p>\n          Results\u2002Technical success was achieved in 100\u200a% of cases in both groups and total operative time was comparable (AG\u200a\u2013\u200a65\u200a\u00b1\u200a17.65 minutes versus PG\u200a\u2013\u200a61.2\u200a\u00b1\u200a16.67; P\u200a=\u200a0.38); Mucosotomies were more frequent in AG (20\u200a% vs 3.3\u200a%; P\u200a=\u200a0.02). Difference in other perioperative adverse events (AE) including insufflation-related AE and bleeding in both groups were statistically insignificant. At 1-month follow-up Eckardt score AG 0.57\u200a\u00b1\u200a0.56 vs PG 0.53\u200a\u00b1\u200a0.71; (P\u200a=\u200a0.81), mean LES pressure AG 11.93\u200a\u00b1\u200a6.36 vs PG 11.77\u200a\u00b1\u200a6.61; (P\u200a=\u200a0.59) and esophageal emptying on timed barium swallow at 5 minutes AG 1.32\u200a\u00b1\u200a1.08\u200acm vs PG 1.29\u200a\u00b1\u200a0.79\u00a0cm; (P\u200a=\u200a0.09) were comparable in both groups. At 3 months, Eckardt score (0.52\u200a\u00b1\u200a0.59 vs 0.63\u200a\u00b1\u200a0.62; P\u200a=\u200a0.51) was similar in both groups. Incidence of esophagitis on EGD was comparable in both groups (24\u200a% vs 33.3\u200a%; P\u200a=\u200a0.45), however, pH metry at 3 months showed significantly more esophageal acid exposure in posterior group (2.98\u200a%\u200a\u00b1\u200a4.24 vs 13.99\u200a%\u200a\u00b1\u200a14.48; P\u200a&lt;\u200a0.01). At 6 months clinical efficacy and LES pressures were comparable in both groups. <\/jats:p><jats:p>\n          Conclusion\u2002Anterior and posterior approaches to POEM seem to have equal efficacy. However, the occurrence of mucosotomies was higher in the anterior myotomy group and acid exposure was higher with the posterior myotomy approach during POEM. <\/jats:p>","DOI":"10.1055\/s-0043-121877","type":"journal-article","created":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T23:39:01Z","timestamp":1517528341000},"page":"E190-E198","source":"Crossref","is-referenced-by-count":82,"title":["Outcomes of anterior myotomy versus posterior myotomy during POEM: a randomized pilot study"],"prefix":"10.1055","volume":"06","author":[{"given":"Mohan","family":"Ramchandani","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaheer","family":"Nabi","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Talele","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh","family":"Darisetty","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rama","family":"Kotla","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhika","family":"Chavan","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manu","family":"Tandan","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,2,1]]},"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-121877.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T20:10:58Z","timestamp":1557173458000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-121877"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2]]},"references-count":0,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2018,2,1]]},"published-print":{"date-parts":[[2018,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-121877","relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2]]}}}