{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T19:31:44Z","timestamp":1767987104135,"version":"3.49.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T00:00:00Z","timestamp":1624838400000},"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":[[2021,12,24]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Peroral endoscopic myotomy (POEM) in patients with achalasia who are status post bariatric surgery may be technically challenging due to postsurgical scarring and altered anatomy. The aim of the study was to assess the efficacy and safety of POEM for achalasia in patients with prior bariatric surgery. A review of prospectively maintained databases at three tertiary referral centers from January 2015 to January 2021 was performed. The primary outcome of interest was clinical success, defined as a post-treatment Eckardt score \u2264\u20093 or improvement in Eckardt score by \u2265\u20091 when the baseline score was &amp;lt;3, and improvement of symptoms. Secondary outcomes were adverse event rates and symptom recurrence. Sixteen patients status post Roux-en-Y gastric bypass (n\u2009=\u200914) and sleeve gastrectomy (n\u2009=\u20092) met inclusion criteria. Indications for POEM were achalasia type I (n\u2009=\u20092), type II (n\u2009=\u20099), and type III (n\u2009=\u20095). POEM was performed either by anterior or posterior approach. The pre-POEM mean integrated relaxation pressure was 26.2\u2009\u00b1\u20097.6 mm Hg. The mean total myotomy length was 10.2\u2009\u00b1\u20092.7 cm. The mean length of hospitalization was 1.4\u2009\u00b1\u20090.7 days. Pre- and postprocedure Eckardt scores were 6.1\u2009\u00b1\u20092.1 and 1.7\u2009\u00b1\u20091.8, respectively. The overall clinical success rate was 93.8% (15\/16) with mean follow-up duration of 15.5 months. One patient had esophageal leak on postprocedure esophagram and managed endoscopically. Dysphagia recurred in two patients, which was successfully managed with pneumatic dilation with or without botulinum toxin injection. POEM appears to be safe and effective in the management of patients with achalasia who have undergone prior bariatric surgery.<\/jats:p>","DOI":"10.1093\/dote\/doab044","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T05:04:00Z","timestamp":1624943040000},"source":"Crossref","is-referenced-by-count":6,"title":["Outcomes of peroral endoscopic myotomy in patients with achalasia and prior bariatric surgery: A multicenter experience"],"prefix":"10.1093","volume":"34","author":[{"given":"S","family":"Bomman","sequence":"first","affiliation":[{"name":"Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J S","family":"Klair","sequence":"additional","affiliation":[{"name":"Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Ashat","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"El Abiad","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Gerke","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Keech","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Parekh","sequence":"additional","affiliation":[{"name":"Division of Bariatric Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Nau","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Hanada","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L M","family":"Wong Kee Song","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Kozarek","sequence":"additional","affiliation":[{"name":"Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Irani","sequence":"additional","affiliation":[{"name":"Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Low","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Virginia Mason Medical Center, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Ross","sequence":"additional","affiliation":[{"name":"Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Krishnamoorthi","sequence":"additional","affiliation":[{"name":"Digestive 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