{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:54Z","timestamp":1787014074993,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The endoscopic pressure study integrated system (EPSIS) is an endoscopic diagnostic system utilized for evaluation of lower esophageal sphincter function. Although previous studies have determined that EPSIS was effective as a tool for the diagnosis of achalasia, it remains uncertain if EPSIS can detect significant changes before and after peroral endoscopic myotomy (POEM), which is the premier treatment for achalasia. This study aimed to evaluate the effectiveness of EPSIS as an objective diagnostic tool for assessing the clinical effect of POEM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of patients who underwent POEM from January 2022 to December 2023. The patients underwent EPSIS preoperatively and 2\u2009months postoperatively. Intragastric pressure (IGP) parameters, including the maximum IGP, IGP difference, and waveform gradient were compared pre\u2010 and post\u2010POEM. These parameters also were compared between two groups: the postoperative gastroesophageal reflux disease (GERD) group and the non\u2010GERD group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 50 patients were analyzed. The mean maximum IGP was significantly lower postoperatively than preoperatively (15.0\u2009mmHg vs. 19.8\u2009mmHg,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The mean IGP difference and waveform gradient were also significantly lower postoperatively than preoperatively (8.0\u2009mmHg vs. 12.2\u2009mmHg,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001; and 0.26\u2009mmHg\/s vs. 0.43\u2009mmHg\/s,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001, respectively). The mean postoperative waveform gradient was significantly lower in the GERD group (17 patients, 34%) than in the non\u2010GERD group (33 patients, 66%) (0.207\u2009mmHg vs. 0.291\u2009mmHg,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.034).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results supported the use of EPSIS as an effective diagnostic tool for assessing the effect of POEM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.14882","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T01:24:42Z","timestamp":1721265882000},"page":"157-166","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of peroral endoscopic myotomy on the endoscopic pressure study integrated system"],"prefix":"10.1111","volume":"37","author":[{"given":"Yohei","family":"Nishikawa","sequence":"first","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiro","family":"Inoue","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8776-6663","authenticated-orcid":false,"given":"Ippei","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotaro","family":"Ito","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo 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Toyosu Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4773-8769","authenticated-orcid":false,"given":"Akiko","family":"Toshimori","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6126-5684","authenticated-orcid":false,"given":"Mayo","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Onimaru","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayoshi","family":"Ito","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center 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