{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T10:31:31Z","timestamp":1772274691099,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:00:00Z","timestamp":1686182400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 DK125266"],"award-info":[{"award-number":["K23 DK125266"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Myotomy length in type 3 achalasia is generally tailored based on segment of spasticity on high\u2010resolution manometry (HRM). Potential of length of tertiary contractions on barium esophagram (BE) or length of thickened circular muscle on endoscopic ultrasound (EUS) to guide tailored myotomy is less understood. This study aimed to assess agreement between spastic segments lengths on HRM, BE, and EUS among patients with type 3 achalasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included adults with type 3 achalasia on HRM between November 2019 and August 2022 who underwent evaluation with EUS and\/or BE. Spastic segments were defined as HRM\u2014distance between proximal borders of lower esophageal sphincter and high\u2010pressure area (isobaric contour \u226570\u2009mmHg); EUS\u2014length of thickened circular muscle (\u22651.2\u2009mm) from proximal border of esophagogastric junction (EGJ) to the transition to a non\u2010thickened circular muscle; BE\u2014distance between EGJ to proximal border of tertiary contractions. Pairwise comparisons assessed for correlation (Pearson's) and intraclass correlation classification (ICC) agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Twenty\u2010six patients were included: mean age 66.9\u2009years (SD 13.8), 15 (57.7%) male. Spastic segments were positively correlated on HRM and BE with good agreement (ICC 0.751, [95% CI 0.51, 0.88]). Spastic segments were negatively correlated with poor agreement on HRM and EUS (ICC \u22120.04, [\u22120.45, 0.39]) as well as BE and EUS (ICC \u22120.03, [\u22120.47, 0.42]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Length of spastic segment was positively correlated on HRM and BE while negatively correlated when compared to EUS, supporting the common use of HRM and highlighting the uncertain role for EUS in tailoring myotomy length for type 3 achalasia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14625","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T09:44:05Z","timestamp":1686217445000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Diagnostic methods to measure spastic segment and guide tailored myotomy length in type 3 achalasia"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0852-8005","authenticated-orcid":false,"given":"Eric E.","family":"Low","sequence":"first","affiliation":[{"name":"Division of Gastroenterology University of California, San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aws","family":"Hasan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of California, San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Abbas","family":"Fehmi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of California, San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of California, San Diego  San Diego California 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