Quantification of Esophageal Angulation in Sigmoid Achalasia: Are We There Yet?

摘要

We read the manuscript entitled “Morphologic restoration after peroral endoscopic myotomy in sigmoid-type achalasia” with great interest.1 In this manuscript, the authors evaluated the change in esophageal tortuosity after per-oral endoscopic myotomy (POEM) as described by the “Descriptive rules for achalasia of the esophagus.”2 Timed barium esophagogram (TBE) is commonly utilized to document the success after POEM or any other treatment modality. The traditional rules of assessing the clinical success using TBE, ie, greater than 50% reduction in barium height may not apply to sigmoid achalasia.3 Therefore, other parameters such as change in esophageal angulation, reduction in diameter of esophagus, and widening of esophagogastric junction opening are used to objectify the treatment outcomes in these cases.