{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:33:45Z","timestamp":1769024025453,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"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":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Pediatric achalasia and peroral endoscopic myotomy (POEM) are not well investigated. This study aimed to examine the clinical characteristics of pediatric achalasia and evaluate the long\u2010term outcomes of POEM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a multicenter study across 14 high\u2010volume centers, comparing the clinical characteristics of children (aged &lt;\u200918\u2009years) diagnosed with achalasia to those of adults (aged &lt;\u200965\u2009years). The POEM procedures and outcomes were also compared between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 3421 patients with achalasia, 50 (1.5%) were children. Compared with adults, children had a shorter period to diagnosis (1.0 vs. 3.4\u2009years; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and were more likely to be severely underweight (body mass index: 17.8 vs. 20.9\u2009kg\/m<jats:sup>2<\/jats:sup>; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). However, children exhibited less esophageal dilation (46.0% vs. 64.1%; <jats:italic>p<\/jats:italic>\u2009=\u20090.013) and higher lower esophageal sphincter pressure (37.3 vs. 29.9\u2009mmHg; <jats:italic>p<\/jats:italic>\u2009=\u20090.002). Notably, a significant failure to thrive was not observed in the pediatric group. The POEM procedure time was shorter for children compared to adults (58.0 vs. 83.0\u2009min; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Clinical success rates were not significant between the two groups. Over the 5\u2010year follow\u2010up period, children had a lower incidence of reflux esophagitis following POEM compared to adults (11.0% vs. 26.4%; <jats:italic>p<\/jats:italic>\u2009=\u20090.013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pediatric achalasia is rare and typically presents with early\u2010stage manometric and esophagogastric features, along with severe systemic symptoms requiring an early diagnosis. POEM is a durable and effective treatment for pediatric achalasia, offering advantages such as shorter procedural times and a lower incidence of postprocedure reflux compared to adults.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16945","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T00:28:31Z","timestamp":1743294511000},"page":"1446-1453","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Characteristics and Long\u2010Term Efficacy of Peroral Endoscopic Myotomy in Pediatric Achalasia"],"prefix":"10.1111","volume":"40","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\u2010Toyosu Hospital  Tokyo 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Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junya","family":"Shiota","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; 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, School of Medicine Tohoku University  Sendai Miyagi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenta","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Practical Gastrointestinal Endoscopy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences Okayama University  Okayama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Ominami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine Osaka Metropolitan 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