{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:25:19Z","timestamp":1787883919711,"version":"build-2784847793"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Achalasia is a motility condition defined by failure of relaxation of the lower esophageal sphincter and loss of peristalsis in the distal esophagus. Per-oral endoscopic myotomy (POEM) is a technique to reduce lower esophageal sphincter pressure. We performed a systematic review and meta-analysis to assess the association between POEM and the clinical outcomes. We performed a systematic review and a meta-analysis (CRD420251052240). Literature search was done on PubMed and Embase (up to 8 June 2025). Original studies involving achalasia patients who underwent esophageal POEM with impedance planimetry using 8-cm balloon at 30 or 40\u00a0mL filling volumes with 325 catheter only (not the 322-N catheter) were included. The outcomes of interest were the clinical response groups (responders\u2019 Eckardt score [ES]\u2009&amp;lt;\u20093 and non-responders\u2019 ES\u2009&amp;gt;\u20093), reflux esophagitis, cross-sectional area (CSA), distensibility index (DI), and diameter. Nineteen studies with 1215 patients were included. The responders (ES\u2009&amp;lt;\u20093) showed a statistically significantly greater increase in DI due to POEM (post-op minus pre-op) (mean difference [MD]\u2009=\u20091.92\u00a0mm2\/mmHg [0.32, 3.53], P\u2009=\u20090.02) as well as a higher postoperative DI (MD\u2009=\u20091.87\u00a0mm2\/mmHg [0.04, 3.70], P\u2009=\u20090.05) (40\u00a0mL). Reflux esophagitis group had statistically significantly higher CSA and diameter values (CSA MD\u2009=\u200915.68\u00a0mm2 [6.91, 24.24], P\u2009=\u20090.0005) (diameter MD\u2009=\u20090.96\u00a0mm [0.58, 1.33], P\u2009&amp;lt;\u20090.00001) but no statistically significant difference for DI as compared to the non-reflux esophagitis group (DI MD\u2009=\u20090.19\u00a0mm2\/mmHg [\u22120.51, 0.89], P\u2009=\u20090.59). In achalasia patients undergoing esophageal POEM, a greater interval increase in the DI as well as a higher post-procedural DI absolute value predicts a favorable clinical response. Higher postoperative CSA and diameter were linked to reflux esophagitis.<\/jats:p>","DOI":"10.1093\/dote\/doag054","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:34:16Z","timestamp":1779190456000},"source":"Crossref","is-referenced-by-count":1,"title":["Use of impedance planimetry (325 catheter with 8-cm balloon) improves per-oral endoscopic myotomy outcomes in achalasia patients: a systematic review and a meta-analysis"],"prefix":"10.1093","volume":"39","author":[{"given":"Muhammad Usman","family":"Baig","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Weill Cornell Medicine , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zane","family":"Gouda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Weill Cornell Medicine , New York, NY 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,","place":["Kuwait"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Aziz","family":"Aadam","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Northwestern Medicine Feinberg School of Medicine , Chicago, IL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moamen","family":"Gabr","sequence":"additional","affiliation":[{"name":"Division of Digestive Diseases, University of Cincinnati , Cincinnati, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehan","family":"Haidry","sequence":"additional","affiliation":[{"name":"Cleveland Clinic London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Mayo Clinic Healthcare in London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badih Joseph","family":"Elmunzer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Center for Digestive Health and Surgery, Atrium Health\u2013Wake Forest University School of Medicine , Charlotte, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felice H","family":"Schnoll-Sussman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Weill Cornell Medicine , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Leslie","family":"Carr-Locke","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Weill Cornell Medicine , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip O","family":"Katz","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Weill Cornell Medicine , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Erik","family":"Pandolfino","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Northwestern Medicine Feinberg School of Medicine , Chicago, IL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem Z","family":"Sharaiha","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Weill Cornell Medicine , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"2026061513255456300_ref1","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1016\/S0016-5085(99)70493-2","article-title":"Chest pain in achalasia: patient characteristics and clinical 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