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Gastrointest Endosc 2021 May 11. Epub 2021 May 11.

Division of Gastroenterology, Hepatology & Nutrition, NYU-Winthrop Hospital, Mineola, NY, USA.

Background And Aims: Peroral endoscopic myotomy (POEM) is becoming the treatment of choice for achalasia. Data beyond 3 years are emerging but limited. We herein report our 10-year experience, focusing on long-term efficacy and safety including the prevalence, management, and sequelae of postoperative reflux. Read More

Khirurgiia (Mosk) 2021 (5):104-108

Spasokukotskiy Clinical Hospital, Moscow, Russia.

Esophageal achalasia is an esophageal motility disease characterized by impaired relaxation of lower esophageal sphincter (LES) and severe clinical symptoms. The main etiological factors and other essential aspects of pathogenesis and progression of this disorder are actively studied. To date, the question of significance of etiological factors is experimental and requires further study. Read More

J Gastrointest Surg 2021 May 6. Epub 2021 May 6.

Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.

Background: The treatment of esophagogastric junction outflow obstruction (EGJOO) currently mirrors that of achalasia, but this is based on only a few studies on small case series. The aim of this prospective, controlled study was to assess the outcome of laparoscopic Heller-Dor (LHD) in patients with EGJOO, as compared with patients with esophageal achalasia.

Materials And Methods: Between 2016 and 2019, patients with manometric diagnosis of idiopathic EGJOO and patients with radiological stage I achalasia, both treated with LHD, were compared. Read More

Surg Endosc 2021 May 4. Epub 2021 May 4.

Division of Thoracic Surgery, Department of Surgery, Houston Methodist Hospital, 6550 Fannin Street, Suite 1661, Houston, TX, 77030, USA.

Background: Manometry is the gold standard diagnostic test for achalasia. However, there are incidences where manometry cannot be obtained preoperatively, or the results of manometry is inconsistent with the patient's symptomatology. We aim to determine if intraoperative use of EndoFLIP can provide a diagnosis of achalasia and provide objective information during Heller myotomy and Dor fundoplication. Read More

Ann Gastroenterol 2021 25;34(3):331-336. Epub 2021 Jan 25.

Norton Thoracic Institute, St. Joseph's Hospital and Medical Center (Balazs Kovacs, Takahiro Masuda, Ross M. Bremner, Sumeet K. Mittal).

Background: Primary absent contractility is an uncommon finding on high-resolution manometry (HRM). The goal of this study was to describe the clinical spectrum and presentation of patients with primary absent contractility.

Methods: We queried a prospectively maintained esophageal testing registry to identify patients with absent contractility who presented between August 2016 and September 2018. Read More

Exp Ther Med 2021 Jun 14;21(6):604. Epub 2021 Apr 14.

5th Clinical Department, Gastroenterology and Internal Medicine Discipline, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

This prospective study aimed to determine the manometric pattern and the prevalence of esophageal dysmotility in 79 morbidly obese patients selected for laparoscopic sleeve gastrectomy. After clinical evaluation and upper gastrointestinal endoscopy, high-resolution esophageal manometry was performed. The esophageal peristalsis, lower esophageal sphincter (LES) basal pressure, and LES relaxation were evaluated. Read More

Gastroenterology 2021 Apr 28. Epub 2021 Apr 28.

Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons; New York, NY, USA. Electronic address:

Dtsch Med Wochenschr 2021 Apr 30;146(9):608-612. Epub 2021 Apr 30.

Klinik für Gastroenterologie, Gastroenterologische Tumortherapie und Diabetologie, Gemeinschaftsklinikum Mittelrhein, Kemperhof, Koblenz.

Since the first publication of peroral endoscopic myotomy (POEM) by Haruhiro Inoue et al. in 2008 in Japan, various novel endoscopic procedures have been established, which are performed after iatrogenic creation of a submucosal tunnel as a "new space" 1. Through the artificially formed access in the tela submucosa, interventions in the muscular layer of the esophagus and stomach can be performed while carefully sparing the mucosal layer 2. Read More

Gastroenterology 2021 Apr 27. Epub 2021 Apr 27.

Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address:

PLoS One 2021 30;16(4):e0250503. Epub 2021 Apr 30.

Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany.

Background And Aim: Achalasia represents a chronic motility disorder of the esophagus featuring an impaired lower esophageal sphincter relaxation and loss of esophageal peristalsis. By causing dysphagia, regurgitation, aspiration and chest pain, achalasia might tremendously affect life quality of patients. However, the impact of achalasia on the development of mood disorders including depression has largely remained unclear. Read More

Obes Surg 2021 Apr 29. Epub 2021 Apr 29.

Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini n.5, 80131, Naples, Italy.

Ann Surg 2021 Jun;273(6):1135-1140

Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.

Objective: We aim to describe the long-term follow-up data from our institution's POEM experience.

Summary Background Data: Per-oral endoscopic myotomy (POEM) is a well-established endoscopic therapy for achalasia with excellent short-term efficacy, but long-term outcomes data are limited.

Methods: Patients older than 4 years removed from POEM for treatment of achalasia were studied. Read More

Pan Afr Med J 2021 8;38:138. Epub 2021 Feb 8.

Department of General Surgery, Carlo Urbani Hospital, Jesi, Ancona, Italy.

Clin Gastroenterol Hepatol 2021 Apr 24. Epub 2021 Apr 24.

Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address:

Background And Aims: We aimed to 1) systemically describe the landscape of Peroral Endoscopic Myotomy (POEM) related adverse events (AE) and compare the different grading systems; 2) establish and validate a combined risk factor model and a simplified risk-scoring system to predict POEM related major AEs (mAEs).

Methods: 3,135 achalasia patients treated with POEM were included and the AEs were systemically described and graded. A predictive model and risk-scoring system was developed using logistic regression and then internally validated using bootstrapping approaches. Read More

VideoGIE 2021 Apr 12;6(4):167-169. Epub 2021 Feb 12.

University of California, San Diego, La Jolla, California.

Turk J Gastroenterol 2021 Jan;32(1):42-52

Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Background/aims: Patients with achalasia have a high incidence of esophageal squamous cell carcinoma (ESCC), which may be associated with alterations in oral and esophageal microbiota caused by food stasis. This study compared the oral and esophageal microbiota of patients with achalasia before and after peroral endoscopic myotomy (POEM). It also compared patients with achalasia to those with ESCC. Read More

Endoscopy 2021 05 22;53(5):557. Epub 2021 Apr 22.

Gastrointestinal Endoscopy Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Endoscopy 2021 05 22;53(5):v20. Epub 2021 Apr 22.

World J Surg 2021 Apr 20. Epub 2021 Apr 20.

Department of Surgery, Escola Paulista de Medicina, Sao Paulo, Brazil.

JSLS 2021 Jan-Mar;25(1)

Department of Surgery, University of Szeged, Albert Szent-Györgyi Health Center, Szeged, Hungary.

Introduction: We have analyzed the short- and long-term results of various surgical therapies for achalasia, especially changes in postoperative esophageal function.

Patients And Methods: Between January 1, 2008 and December 31, 2017, 54 patients with esophageal achalasia were treated in our institution. Patients scheduled for surgery underwent a comprehensive gastroenterological assessment pre- and post-surgery. Read More

Neurogastroenterol Motil 2021 Apr 19:e14133. Epub 2021 Apr 19.

Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Background: Achalasia is an esophageal motility disorder characterized by esophagogastric junction (EGJ) dysfunction and impaired esophageal peristalsis with significant impact on quality of life. While the functional luminal imaging probe (FLIP) has been used to assess EGJ distensibility in achalasia, its clinical utility in pediatrics is limited due to absence of normative values and correlations with clinical outcomes in children. Thus, we sought to evaluate FLIP's use in a pediatric achalasia cohort undergoing dilations and non-achalasia controls. Read More

Curr Opin Gastroenterol 2021 Apr 14. Epub 2021 Apr 14.

Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, the Netherlands Department of Gastroenterology and Hepatology, GZA Hospitals Department of Gastroenterology and Hepatology, Antwerp University Hospital, Antwerp, Belgium.

Purpose Of Review: Idiopathic achalasia is a primary motility disorder of the esophagus that results in dysphagia, weight loss, and impaired quality of life. Several treatment options are available to gastroenterologists, and insights on the long-term outcome of these modalities are discussed.

Recent Findings: Peroral endoscopic myotomy (POEM) represents a novel endoscopic technique in the treatment of achalasia. Read More

Obes Surg 2021 Jun 15;31(6):2843-2844. Epub 2021 Apr 15.

Service de Chirurgie Digestive, Clinique Geoffroy Saint Hilaire, Ramsay Santé, Paris, France.

Introduction: Achalasia after bariatric surgery is a rare pathological entity. Nonetheless, several cases have been described in literature. Per oral endoscopic myotomy has recently emerged as the preferred approach for the management of esophageal motility disorders. Read More

Dysphagia 2021 Apr 14. Epub 2021 Apr 14.

Department of Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Campus da USP, Ribeirão Preto, SP, Brazil.

Chagas disease, caused by the infection of the protozoan parasite Trypanosoma cruzi, has clinical consequences in the heart and digestive tract. The most important changes in the digestive tract occur in the esophagus (megaesophagus) and colon (megacolon). Esophageal dysfunction in Chagas disease results from damage of the esophageal myenteric plexus, with loss of esophageal peristalsis, partial or absent lower esophageal sphincter relaxation, and megaesophagus, which characterizes secondary esophageal achalasia. Read More

Rev Col Bras Cir 2021 9;48:e20202973. Epub 2021 Apr 9.

- Centro Universitário Lusíada, Departamento de Medicina Baseada em Evidências - Santos - SP - Brasil.

Am J Gastroenterol 2021 Apr 13. Epub 2021 Apr 13.

Gastroenterology Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy; Gastroenterology Unit, Department of Oncological Gastrointestinal Surgery, S. Maria del Prato Hospital, Feltre, Italy.

J Transl Int Med 2021 Mar 31;9(1):24-31. Epub 2021 Mar 31.

Department of Gastroenterology, ShengJing Hospital of China Medical University, Shenyang, Liaoning Province, China.

Idiopathic achalasia is an esophageal motor disorder characterized by the loss of the lower esophageal sphincter ganglion, resulting in impaired lower esophageal relaxation and absence of esophageal peristalsis. Patients commonly present with progressive dysphagia accompanied by reflux, heartburn, retrosternal pain, and severe weight loss. Diagnosis is primarily based on the patient's chief complaints, barium esophagography, and the most recent high-resolution manometry. Read More

Esophagus 2021 Apr 13. Epub 2021 Apr 13.

Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.

Introduction: The American Society of Anesthesiologists (ASA) physical status classification system was developed as a simple categorization of patients' physiological status that predicts the operative risk. Peroral endoscopic myotomy (POEM) is a less invasive alternative to surgical myotomy in achalasia. As such, POEM seems to be an appealing option for high-risk patients with achalasia. Read More

Int J Med Robot 2021 Mar 24:e2253. Epub 2021 Mar 24.

Division of General, Minimally Invasive & Robotic Surgery, University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA.

Background: Robotic-assisted laparoscopic Heller myotomy has been proposed as an alternative minimally invasive approach to traditional laparoscopy for the treatment of achalasia. This systematic review aims to compare the safety and post-operative outcomes of the two procedures.

Methods: Systematic literature search was performed in MEDLINE through Ovid, Scopus and Cochrane to identify clinical trials and retrospective analyses. Read More

J Thorac Cardiovasc Surg 2021 Mar 15. Epub 2021 Mar 15.

Division of Thoracic Surgery, Department of Thoracic Medicine and Surgery, Temple University Hospital and Fox Chase Comprehensive Cancer Center, Philadelphia, Pa. Electronic address: