Upper Esophageal Sphincter Abnormalities and Esophageal Motility Recovery After Peroral Endoscopic Myotomy for Achalasia.
Sihui Lin, Tiancheng Luo, Zhilong Chen and 4 others
PMID 39592506WHAT IT FOUND
Most achalasia patients had upper sphincter issues that improved after surgery.
Those with these issues started with worse swallowing scores. The surgery lowered pressure at both sphincters and helped symptoms, but it did not restore normal muscle movement in the esophagus.
Key findings
01Sixty-five percent of patients had upper esophageal sphincter abnormalities, which were linked to more severe pre-surgery symptoms.
02Surgery significantly reduced pressure in both the upper and lower esophageal sphincters and improved symptom scores across all groups.
03The surgery did not restore normal muscle movement in the esophagus for most patients, particularly those with Type I achalasia.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was retrospective and single-center, which may introduce selection bias. The sample size was small (64 patients), limiting the generalizability of the findings. The follow-up period was only six months, so long-term stability of the results is unknown. Impedance monitoring was not used, so the study could not directly assess how food moved through the upper sphincter.
Declared interests
Funded by the Natural Science Foundation of Fujian Province, Fujian Provincial Health Technology Project, and Xiamen key medical and health project. No conflicts of interest declared.
The easy way to misread this
Do not assume that successful symptom relief after POEM means the esophagus has regained normal muscle function. The study shows that while pressure decreases and symptoms improve, normal peristalsis often does not return, especially in Type I achalasia.