
PMID- 42555391
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20260805
LR  - 20260813
IS  - 2049-0801 (Print)
IS  - 2049-0801 (Electronic)
IS  - 2049-0801 (Linking)
VI  - 88
IP  - 7
DP  - 2026 Jul
TI  - Short versus long myotomy during peroral endoscopic myotomy for achalasia: a 
      systematic review and meta-analysis.
PG  - 4448-4456
LID - 10.1097/MS9.0000000000005074 [doi]
AB  - BACKGROUND: Peroral endoscopic myotomy (POEM) is an established treatment 
      modality for achalasia. This meta-analysis aimed to compare the clinically 
      relevant outcomes of short and long myotomy during POEM for achalasia. METHODS: 
      PubMed, Cochrane Central, and ScienceDirect were systematically searched from 
      inception to February 2025. The risk ratios (RRs) and mean differences (MDs) were 
      pooled using the random-effects model in Review Manager. Quality assessment was 
      conducted using the Cochrane Risk of Bias (RoB 2.0) tool and the Newcastle-Ottawa 
      Scale. RESULTS: Seven studies, pooling a total of 737 patients, were included in 
      the analysis. The short myotomy showed no significant difference in clinical 
      success [RR: 1.02; 95% CI: (0.99-1.05); P = 0.19], Eckardt score (P = 0.45), or 
      lower esophageal sphincter pressure (P = 0.72) compared to the long myotomy. 
      Similarly, the integrated relaxation pressures (P = 0.73), duration of 
      hospitalization (P = 0.67), and the risk of erosive esophagitis (P = 0.13) were 
      comparable between the two arms. The short myotomy arm significantly reduced 
      overall procedural duration [MD: -15.84; 95% CI: (-21.05 to -10.63); P 
      < 0.00001]. Short myotomy was also associated with a significantly lower risk of 
      abnormal esophageal acid exposure [RR: 0.64; 95% CI: (0.43-0.95); P = 0.03]. 
      CONCLUSION: Short myotomy was associated with a significant reduction in 
      procedural time and risk of abnormal esophageal acid exposure, whereas the 
      remaining efficacy and safety endpoints were comparable between the two 
      techniques.
CI  - Copyright (c) 2026 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Ul Abideen, Zain
AU  - Ul Abideen Z
AD  - King Edward Medical University, Lahore, Pakistan.
FAU - Waseem, Muhammad Hassan
AU  - Waseem MH
AD  - Allama Iqbal Medical College, Lahore, Pakistan.
FAU - Ali, Rimmel
AU  - Ali R
AD  - Dow Medical College, Karachi, Pakistan.
FAU - Chu, Avan
AU  - Chu A
AD  - Wayne State University School of Medicine, Detroit, MI, USA.
FAU - Hameed, Muhammad Sheraz
AU  - Hameed MS
AD  - Rawalpindi Medical University, Rawalpindi, Pakistan.
FAU - Abdullah
AU  - Abdullah
AD  - Rawalpindi Medical University, Rawalpindi, Pakistan.
FAU - Ramzan, Noor-Ul-Huda
AU  - Ramzan NU
AD  - UT Southwestern Medical Center, Dallas, TX, USA.
FAU - Thada, Pawan Kumar
AU  - Thada PK
AUID- ORCID: 0000-0002-2085-8739
AD  - Sotang Primary Hospital, Solukhumbu, Nepal.
FAU - Kumar Jalal, Prasun
AU  - Kumar Jalal P
AD  - Baylor College of Medicine, TX, USA.
LA  - eng
PT  - Journal Article
DEP - 20260515
PL  - England
TA  - Ann Med Surg (Lond)
JT  - Annals of medicine and surgery (2012)
JID - 101616869
PMC - PMC13354361
OTO - NOTNLM
OT  - achalasia
OT  - esophagus
OT  - meta-analysis
OT  - myotomy
OT  - peroral endoscopic myotomy
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2026/08/05 18:38
MHDA- 2026/08/05 18:39
PMCR- 2026/05/15
CRDT- 2026/08/05 12:46
PHST- 2025/10/19 00:00 [received]
PHST- 2026/04/04 00:00 [accepted]
PHST- 2026/08/05 18:39 [medline]
PHST- 2026/08/05 18:38 [pubmed]
PHST- 2026/08/05 12:46 [entrez]
PHST- 2026/05/15 00:00 [pmc-release]
AID - AMSU-D-25-03175 [pii]
AID - 10.1097/MS9.0000000000005074 [doi]
PST - epublish
SO  - Ann Med Surg (Lond). 2026 May 15;88(7):4448-4456. doi: 
      10.1097/MS9.0000000000005074. eCollection 2026 Jul.
