Association between preoperative pan-esophageal pressurization and peristalsis recovery after per-oral endoscopic myotomy in achalasia.

IF 4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Report Pub Date : 2026-08-04 eCollection Date: 2026-02-01 DOI:10.1093/gastro/goag081

Dianxuan Jiang, Ruoxi Zhang, Peiwen Dong, Shimin Chen, Wei Zhao, Songfeng Chen, Niandi Tan, Mengyu Zhang, Qianjun Zhuang, Xiaoqing Li, Qiong Wang, Nina Zhang, Yinglian Xiao

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引用次数: 0

Abstract

Background: Per-oral endoscopic myotomy (POEM) has become the mainstream treatment for achalasia. Previous studies have found that some patients with achalasia might experience partial recovery of esophageal peristalsis after POEM. However, the clinical significance of this recovery and the associated factors remain to be further elucidated.

Methods: This was a multicenter retrospective cohort study conducted by four academic hospitals in China. Patients diagnosed with achalasia who underwent POEM between 2020 and 2025 were included. Demographics, Eckardt score, gastroesophageal reflux disease questionnaire (GERDQ) score, presence of esophagitis, high-resolution manometry parameters, and myotomy length were collected. Normal, weak, and fragmented contractions were defined as partial recovery of esophageal peristalsis.

Results: Partial recovery of esophageal peristalsis was observed in 32.8% (95 of 290) of patients with achalasia. A significantly higher preoperative proportion of pan-esophageal pressurization was found in the recovery group compared with the non-recovery group [median (interquartile range), 80.0% (30.0%, 100.0%) vs 30.0% (0.0%, 90.0%), P < 0.001] and this proportion positively correlated with the degree of peristalsis recovery (r = 0.247, P < 0.001). Patients with peristalsis recovery had significantly lower GERDQ scores and reduced incidence of dysphagia symptoms. Multivariate analysis further confirmed that the preoperative proportion of pan-esophageal pressurization was an independent predictor of peristalsis recovery (odds ratio = 1.02, P = 0.007).

Conclusions: A higher preoperative proportion of pan-esophageal pressurization was independently associated with postoperative recovery of esophageal peristalsis in patients with achalasia. Peristalsis recovery was related to superior symptom relief. Preoperative assessment of pan-esophageal pressurization might help guide individualized postoperative follow-up and patient counseling.

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贲门失弛缓症经口内窥镜肌切开术后术前全食管加压与肠蠕动恢复的关系。

背景：经口内窥镜下肌切开术（POEM）已成为贲门失弛缓症的主流治疗方法。既往研究发现，部分贲门失弛缓症患者经POEM后可能出现部分食管蠕动恢复。然而，这种恢复的临床意义及其相关因素仍有待进一步阐明。方法：这是一项由中国四所学术医院进行的多中心回顾性队列研究。纳入了在2020年至2025年间接受POEM治疗的贲门失弛缓症患者。收集人口统计学、Eckardt评分、胃食管反流疾病问卷（GERDQ）评分、食管炎的存在、高分辨率测压参数和切肌长度。正常、微弱、碎片性收缩定义为食管蠕动部分恢复。结果：290例贲门失弛缓症患者中有95例（32.8%）食管蠕动部分恢复。术前全食管加压比例恢复组明显高于未恢复组[中位数（四分位数间距）：80.0% (30.0%,100.0%)vs 30.0% (0.0%, 90.0%), P r = 0.247, P P = 0.007]。结论：贲门失弛缓症患者术前较高的全食管加压比例与术后食管蠕动恢复独立相关。蠕动恢复与症状明显缓解有关。术前评估全食管加压可能有助于指导个体化术后随访和患者咨询。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastroenterology Report Medicine-Gastroenterology

CiteScore

4.60

自引率

2.80%

发文量

审稿时长

8 weeks

期刊介绍： Gastroenterology Report is an international fully open access (OA) online only journal, covering all areas related to gastrointestinal sciences, including studies of the alimentary tract, liver, biliary, pancreas, enteral nutrition and related fields. The journal aims to publish high quality research articles on both basic and clinical gastroenterology, authoritative reviews that bring together new advances in the field, as well as commentaries and highlight pieces that provide expert analysis of topical issues.