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Record W4410813906 · doi:10.1159/000546490

Endoscopic Treatment of Achalasia

2025· review· en· W4410813906 on OpenAlexaff
Gonzalo Latorre, Robert Bechara

Bibliographic record

VenueDigestion · 2025
Typereview
Languageen
FieldMedicine
TopicGastroesophageal reflux and treatments
Canadian institutionsKingston Health Sciences CentreKingston General HospitalQueen's University
Fundersnot available
KeywordsAchalasiaMyotomyEsophageal motility disorderGERDMedicineBotulinum toxinHeller myotomyIntensive care medicineEsophagusSurgeryDiseaseRefluxInternal medicine

Abstract

fetched live from OpenAlex

BACKGROUND: Achalasia is the most common major esophageal motility disorder, characterized by impaired lower esophageal sphincter relaxation and absent or ineffective peristalsis. Peroral endoscopic myotomy (POEM), pneumatic dilation, and botulinum toxin injection are the main endoscopic therapies available. This review highlights recent advances, technical variations, and updated evidence on the efficacy and safety of POEM. SUMMARY: POEM has emerged as a highly effective and minimally invasive treatment for achalasia, with randomized controlled trials demonstrating excellent long-term clinical success and durability. Its safety profile and capacity for a tailored myotomy offer distinct advantages over alternative therapies. However, gastroesophageal reflux disease (GERD) remains a key concern. Ongoing efforts are focused on optimizing procedural techniques, including myotomy length and orientation, sling fiber preservation, and the addition of fundoplication. Additionally, training protocols, patient selection criteria, and strategies to prevent and predict GERD are critical areas of development. Future research should aim to refine follow-up strategies and define objective measures of success to enhance the safety, efficacy, and accessibility of POEM. KEY MESSAGES: Endoscopic treatments of achalasia, particularly POEM, offer effective and durable outcomes. Optimizing technique, refining training, and managing GERD are essential for improving safety and long-term success.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.004
Threshold uncertainty score0.015

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0010.001
Open science0.0000.000
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0040.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.047
GPT teacher head0.385
Teacher spread0.338 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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