{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T13:23:59Z","timestamp":1754486639340,"version":"3.41.2"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T00:00:00Z","timestamp":1602633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,8]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n               <jats:p>Peroral endoscopic myotomy (POEM) has been increasingly accepted as the first-line treatment of achalasia. However, laparoscopic Heller myotomy or esophagectomy still remains as the mainstay treatment for advanced achalasia featured with megaesophagus and\/or sigmoid-shaped esophagus. Although the efficacy of POEM for advanced achalasia with sigmoid-shaped esophagus has been described, little is known about the role of POEM for patients with megaesophagus. The aim of our study is to evaluate the efficacy and safety of POEM for advanced achalasia with megaesophagus. Patients who received initial examinations and underwent POEM in our hospital from June 2013 to December 2018 were identified and data were retrospectively analyzed. The advanced achalasia was defined as megaesophagus with a diameter of \u22656\u00a0cm. The primary outcome was clinical success. The secondary outcomes were technical success and adverse events. A total of 112 patients (50 females, 44.6%) were included with a mean age of 44.8\u00a0years. The median symptom duration was 6.5\u00a0years (IQR:3.0\u201313.0\u00a0years). Modified POEM techniques were used in 27.7% (31\/112) of patients. Technical success rate was 99.1% (112\/113) per procedure. Clinical success was seen in 93.1% patients with median Eckardt score decreasing from 8.0 to 1.0 (P\u2009&amp;lt;\u20090.001) during a median 31.0\u00a0months of follow-up. The mean LES pressure decreased from 29.5\u00a0mmHg to 14.2\u00a0mmHg after POEM (P\u2009&amp;lt;\u20090.05). Procedure-related adverse events occurred in 8.9% patients. Reflux disease was observed postoperatively in 26.7% of patients. POEM is also indicated for patients with advanced achalasia with a favorable safety and efficacy.<\/jats:p>","DOI":"10.1093\/dote\/doaa097","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T09:35:53Z","timestamp":1602668153000},"source":"Crossref","is-referenced-by-count":16,"title":["Advanced achalasia: good candidate for peroral endoscopic myotomy"],"prefix":"10.1093","volume":"34","author":[{"given":"Shaotian","family":"Qiu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ningli","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaqi","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangyao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enqiang","family":"Linghu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,10,14]]},"reference":[{"issue":"5","key":"2021031106042436900_ref1","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1007\/s11605-017-3398-x","article-title":"Peroral endoscopic myotomy for type III achalasia of Chicago classification: outcomes with a minimum follow-up of 24 months","volume":"21","author":"Zhang","year":"2017","journal-title":"J Gastrointest Surg"},{"issue":"6","key":"2021031106042436900_ref2","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1038\/nrgastro.2015.45","article-title":"Therapeutic options in oesophageal dysphagia","volume":"12","author":"Tack","year":"2015","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2021031106042436900_ref3","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/0003-4975(89)90369-X","article-title":"Esophageal resection for achalasia: indications and 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