{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:52:22Z","timestamp":1789185142831,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,8,8]],"date-time":"2017-08-08T00:00:00Z","timestamp":1502150400000},"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":[[2018,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment for achalasia has traditionally been Heller myotomy (HM). Despite its excellent efficacy rate, a number of patients remain symptomatic post\u2010procedure. Limited data exist as to the best management for recurrence of symptoms post\u2010HM. We present an international, multicenter experience evaluating the efficacy and safety of post\u2010HM peroral endoscopic myotomy (POEM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent POEM post\u2010HM from 13 centers from January 2012 to January 2017 were included as part of a prospective registry. Technical success was defined as successful completion of the myotomy. Clinical success was defined as an Eckardt score of \u22643 on 12\u2010month follow up. Adverse events (AE) including anesthesia\u2010related, operative, and postoperative complications were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010one patients were included in the study (mean age 54.2, 47% male). Technical success was achieved in 100% of patients. Clinical success on long\u2010term follow up was achieved in 48 patients (94%), with a mean change in Eckardt score of 6.25. Seven patients (13%) had AE: six experienced periprocedural mucosal defect treated endoscopically and two patients developed mediastinitis treated conservatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For patients with persistent symptoms after HM, POEM is a safe salvation technique with good short\u2010term efficacy. As a result of the challenge associated with repeat HM, POEM might become the preferred technique in this patient population. Further studies with longer follow up are needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.12918","type":"journal-article","created":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T08:56:43Z","timestamp":1499677003000},"page":"52-56","source":"Crossref","is-referenced-by-count":60,"title":["Peroral endoscopic myotomy as salvation technique post\u2010Heller: International experience"],"prefix":"10.1111","volume":"30","author":[{"given":"Amy","family":"Tyberg","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Weill Cornell Medical College New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem Z.","family":"Sharaiha","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Weill Cornell Medical College New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Familiari","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit 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Gastroenterology and Hepatology Weill Cornell Medical College New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felice","family":"Schnoll\u2010Sussman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Weill Cornell Medical College New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payal","family":"Saxena","sequence":"additional","affiliation":[{"name":"Gastroenterology Johns Hopkins Baltimore USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guadalupe","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Gastroenterology Juarez Hospital Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Zamarripa","sequence":"additional","affiliation":[{"name":"Gastroenterology Juarez Hospital Mexico City 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