{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:36:51Z","timestamp":1770277011450,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:00:00Z","timestamp":1636588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["18 K15805"],"award-info":[{"award-number":["18 K15805"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The perioperative management and clinical course of per\u2010oral endoscopic myotomy for patients receiving antithrombotic therapy remains unknown. This study aimed to clarify the status of antithrombotic therapy in per\u2010oral endoscopic myotomy and to determine its safety and efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients treated with per\u2010oral endoscopic myotomy from 2010 to 2019 in seven high\u2010volume centers in Japan were retrospectively investigated. The patients' characteristics and antithrombotic agent management were analyzed; clinical outcomes were compared with those without antithrombotic agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2752 patients who underwent per\u2010oral endoscopic myotomy, 120 patients on antithrombotic therapy (mean age 71.0\u00a0years, American Society of Anesthesiologists class II\u2013IV [67.5%]) were identified. Antiplatelet, anticoagulant, and a combination of antithrombotic agents were used in 82, 30, and 8 patients, respectively. The perioperative management adhered to the therapeutic endoscopy guidelines published by the Japanese Society of Gastroenterological Endoscopy in most patients (88.3%). A poorer clinical baseline status (American Society of Anesthesiologists class II\u2013IV; 67.0% <jats:italic>vs<\/jats:italic> 24.3%) and the sigmoid type (40.7% <jats:italic>vs<\/jats:italic> 22.3%) were more frequently observed in patients with achalasia on antithrombotic therapy. However, the clinical success (Eckardt score \u2264 3; 97.6% <jats:italic>vs<\/jats:italic> 94.6) and adverse event rates, such as bleeding and thromboembolic events (5.5% <jats:italic>vs<\/jats:italic> 4.7%), did not show inferiority.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Per\u2010oral endoscopic myotomy on antithrombotic therapy is safe and effective. However, caution is required as patients on antithrombotic therapy tend to have poorer baseline health and achalasia statuses. Our experience should help establish perioperative management with antithrombotic therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15708","type":"journal-article","created":{"date-parts":[[2021,10,17]],"date-time":"2021-10-17T22:27:46Z","timestamp":1634509666000},"page":"480-488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Per\u2010oral endoscopic myotomy in patients with antithrombotic agents: A large\u2010scale multicenter study in Japan"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4107-9264","authenticated-orcid":false,"given":"Yuto","family":"Shimamura","sequence":"first","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7766-3724","authenticated-orcid":false,"given":"Hiroki","family":"Sato","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences Niigata University  Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Onimaru","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinwa","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kobe University Hospital  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironari","family":"Shiwaku","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Faculty of Medicine Fukuoka University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junya","family":"Shiota","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiaki","family":"Sato","sequence":"additional","affiliation":[{"name":"Division of Advanced Surgical Science and Technology Tohoku University School of Medicine  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine Oita University  Oita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Yokomichi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Yamanashi  Yamanashi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruhiro","family":"Inoue","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1244080"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1905380"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.8859"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-016-4373-1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13184"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-315131"},{"key":"e_1_2_7_8_1","first-page":"c1","article-title":"Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines","volume":"48","author":"Veitch AM","year":"2016","journal-title":"Endoscopy"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.09.035"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.139"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.07.030"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-08065-7"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14569"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-56534-4"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-018-01544-8"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60651-0"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13239"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.07.017"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12183"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13872"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i30.5557"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-015-0588-7"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.15708","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.15708","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.15708","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T11:57:03Z","timestamp":1693137423000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.15708"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,11]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1111\/jgh.15708"],"URL":"https:\/\/doi.org\/10.1111\/jgh.15708","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,11]]},"assertion":[{"value":"2021-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}