{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:38:03Z","timestamp":1790620683928,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T00:00:00Z","timestamp":1442275200000},"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":[[2016,1]]},"abstract":"<jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Peroral endoscopic myotomy (POEM) does not include any antireflux procedure, resulting in a certain risk of iatrogenic gastroesophageal reflux disease (GERD). The aim of the present study was to evaluate the incidence of iatrogenic GERD after POEM and identify preoperative, perioperative and postoperative factors associated with GERD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients treated at a single center who had a complete GERD evaluation after POEM were included in the study. Demographics, preoperative and follow\u2010up data, results of functional studies and procedural data were collected and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 103 patients (mean age 46.6\u2009years, 47 males) were included. Postoperative altered esophageal acid exposure was attested in 52 patients (50.5%). A total of 19 patients (18.4%) had heartburn and 21 had esophagitis (20.4%). Overall, a clinically relevant GERD (altered esophageal acid exposure, associated with heartburn and\/or esophagitis) was diagnosed in 30 patients (29.1%).<\/jats:p><jats:p>Correlation between the severity of esophageal acid exposure with heartburn and esophagitis after POEM was found. Patients with heartburn had a lower postoperative 4\u2010second integrated relaxation pressure compared to patients without symptoms (7.6\u2009\u00b1\u20093.8\u2009mmHg <jats:italic>vs<\/jats:italic> 10.01\u2009\u00b1\u20094.4\u2009mmHg, <jats:italic>p<\/jats:italic>&lt;0.05). No correlations were identified with patient sex, age, postoperative body mass index, esophageal shape (sigmoid <jats:italic>vs<\/jats:italic> non sigmoid), lower esophageal sphincter pressure, length of myotomy, previous therapies and type of achalasia at high\u2010resolution manometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Preoperative, perioperative or postoperative factors minimally correlated with GERD after POEM. Clinically relevant GERD was identified in less than one\u2010third of patients, but all patients were well controlled with medical therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.12511","type":"journal-article","created":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T22:21:15Z","timestamp":1436912475000},"page":"33-41","source":"Crossref","is-referenced-by-count":105,"title":["Gastroesophageal reflux disease after peroral endoscopic myotomy: Analysis of clinical, procedural and functional factors, associated with gastroesophageal reflux disease and esophagitis"],"prefix":"10.1111","volume":"28","author":[{"given":"Pietro","family":"Familiari","sequence":"first","affiliation":[{"name":"Digestive Endoscopy Unit Gemelli University Hospital, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santi","family":"Greco","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Gemelli University Hospital, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Gigante","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Gemelli University Hospital, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Cal\u00ec","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Gemelli University Hospital, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Bo\u0161koski","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Gemelli University Hospital, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziano","family":"Onder","sequence":"additional","affiliation":[{"name":"Department of Geriatrics Gemelli University Hospital, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Perri","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Gemelli University Hospital, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Costamagna","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Gemelli University Hospital, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60651-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-011-2017-2"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31818e43ab"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000136940.32255.51"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1244080"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-012-2030-3"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.04.051"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000268"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.04.042"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.06.035"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu320"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2012.04.003"},{"key":"e_1_2_6_14_1","article-title":"Peroral Endoscopic Myotomy for Esophageal Achalasia: Outcomes of the First 100 Patients With Short\u2010term Follow\u2010up","author":"Familiari P","year":"2014","journal-title":"Ann. 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