{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:18:02Z","timestamp":1789391882248,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,4,14]],"date-time":"2013-04-14T00:00:00Z","timestamp":1365897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of the present study was to clarify the efficacy of peroral endoscopic myotomy (<jats:styled-content style=\"fixed-case\">POEM<\/jats:styled-content>) for esophageal achalasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Twenty\u2010eight esophageal achalasia patients who underwent <jats:styled-content style=\"fixed-case\">POEM<\/jats:styled-content> in our institution between <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ugust 2010 and <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>ctober 2012 were enrolled. Under general anesthesia with tracheal intubation, initial incision was made on the anterior wall of the esophagus after submucosal injection. Submucosal tunnel was created and extended below the lower esophageal sphincter (<jats:styled-content style=\"fixed-case\">LES<\/jats:styled-content>) onto the gastric cardia. Subsequently, myotomy was done using triangle tip knife. After confirmation of smooth passage of scope through the esophagogastric junction, the entry was closed. Esophagogram and manometry study was done before and after the procedure. Also, subjective symptom score and <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>ckardt score were assessed before and 3 months after <jats:styled-content style=\"fixed-case\">POEM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">POEM<\/jats:styled-content> was successfully done in all cases without any severe complications such as perforation and mediastinitis.Mean procedure time was 99.1\u2009min (range 61\u2013160) and mean myotomy length was 14.4\u2009cm (range 10\u201318). Significant improvement was achieved in both esophagogram and endoscopic findings. Mean <jats:styled-content style=\"fixed-case\">LES<\/jats:styled-content> pressure was 71.2\u2009mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g (35.8\u2013119.0) and 21.0\u2009mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g (6.7\u201341.0) before and after the procedure (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), respectively. Mean <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>ckardt score was 6.7 (3\u201312, median 7) and 0.7 (0\u20133, median 1) before and 3 months after <jats:styled-content style=\"fixed-case\">POEM<\/jats:styled-content>, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Symptomatic gastroesophageal reflux disease that was easily controlled by the usual dose of proton pump inhibitor was seen in six cases (21.4%) after the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">POEM<\/jats:styled-content> could be a curative standard treatment of choice for esophageal achalasia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.12086","type":"journal-article","created":{"date-parts":[[2013,4,15]],"date-time":"2013-04-15T03:50:41Z","timestamp":1365997841000},"page":"43-51","source":"Crossref","is-referenced-by-count":71,"title":["Peroral endoscopic myotomy for esophageal achalasia: <scp>C<\/scp>linical impact of 28 cases"],"prefix":"10.1111","volume":"26","author":[{"given":"Hitomi","family":"Minami","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Isomoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayoko","family":"Matsushima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Akazawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Ohnita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuminao","family":"Takeshima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiro","family":"Inoue","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa University Northern Yokohama Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,14]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"825","article-title":"Long\u2010term clinical and manometric follow\u2010up of patients with nonspecific esophageal motor disorders","volume":"87","author":"Achem SR","year":"1992","journal-title":"Am. 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