Achalasia, from diagnosis to treatment

References

• Pandolfino JE, Gawron AJ. Achalasia: a systematic review. JAMA. 2015;313(18):1841–1852.
   PubMed Web of Science ®Google Scholar
• Savarino E, Bhatia S, Roman S, et al. Achalasia. Nat Rev Dis Primers. 2022;8(1):28.
   PubMedGoogle Scholar
• van Hoeij FB, Ponds FA, Smout AJ, et al. Incidence and costs of achalasia in The Netherlands. Neurogastroenterol Motil. 2018 Feb;30(2):e13195.
   Web of Science ®Google Scholar
• Harvey PR, Thomas T, Chandan JS, et al. Incidence, morbidity and mortality of patients with achalasia in England: findings from a study of nationwide hospital and primary care data. Gut. 2019 May;68(5):790–795.
   PubMed Web of Science ®Google Scholar
• Gaber CE, Eluri S, Cotton CC, et al. Epidemiologic and economic burden of achalasia in the United States. Clin Gastroenterol Hepatol. 2022 Feb;20(2):342–352.e5.
   PubMed Web of Science ®Google Scholar
• Vaezi MF, Pandolfino JE, Yadlapati RH, et al. ACG Clinical guidelines: diagnosis and management of achalasia. Am. J. Gastroenterol. 2020;115:1393–1411. .
   PubMed Web of Science ®Google Scholar
• Oude Nijhuis RAB, Zaninotto G, Roman S, et al. European guidelines on achalasia: united European Gastroenterology and European Society of Neurogastroenterology and Motility recommendations. United European Gastroenterol J. 2020;8(1):13–33.
   PubMedGoogle Scholar
• Eckardt VF, Hoischen T, Bernhard G. Life expectancy, complications, and causes of death in patients with achalasia: results of a 33-year follow-up investigation. Eur. J. Gastroenterol. Hepatol. 2008;20(10):956–960.
   PubMed Web of Science ®Google Scholar
• De Giorgio R, Di Simone MP, Stanghellini V, et al. Esophageal and gastric nitric oxide synthesizing innervation in primary achalasia. Am J Gastroenterol. 1999 Sep;94(9):2357–2362.
   PubMed Web of Science ®Google Scholar
• Wu XY, Liu ZQ, Wang Y, et al. The etiology of achalasia: an immune-dominant disease. J Dig Dis. 2021 Mar;22(3):126–135.
   PubMed Web of Science ®Google Scholar
• Lee BE, Kim GH, Shin N, et al. Histopathological analysis of esophageal mucosa in patients with achalasia. Gut Liver. 2021 Sep 15 15(5):713–722.
   PubMed Web of Science ®Google Scholar
• Robertson CS, Martin BA, Atkinson M. Varicella-zoster virus DNA in the oesophageal myenteric plexus in achalasia. Gut. 1993 Mar;34(3):299–302.
   PubMed Web of Science ®Google Scholar
• Naik RD, Vaezi MF, Gershon AA, et al. Association of achalasia with active varicella zoster virus infection of the esophagus. Gastroenterology. 2021 Aug;161(2):719–721.e2.
   PubMed Web of Science ®Google Scholar
• Kebuchi Y, Kanda T, Ikeda H, et al. Identification of human herpes virus 1 encoded microRNAs in biopsy samples of lower esophageal sphincter muscle during peroral endoscopic myotomy for esophageal achalasia. Dig Endosc. 2020 Jan;32(1):136–142.
   PubMed Web of Science ®Google Scholar
• Facco M, Brun P, Baesso I, et al. T cells in the myenteric plexus of achalasia patients show a skewed TCR repertoire and react to HSV-1 antigens. Am J Gastroenterol. 2008 Jul;103(7):1598–1609.
   PubMed Web of Science ®Google Scholar
• Boeckxstaens GE, Zaninotto G, Richter JE. Achalasia. Lancet. 2014 Jan 4; 383(9911):83–93.
   PubMed Web of Science ®Google Scholar
• Verne GN, Sallustio JE, Eaker EY. Anti-myenteric neuronal antibodies in patients with achalasia. A prospective study. Digestive Dis Sci. 1997;42(2):307–313.
   PubMed Web of Science ®Google Scholar
• Wong RK, Maydonovitch CL, Metz SJ, et al. Significant DQw1 association in achalasia. Digestive Dis Sci. 1989;34(3):349–352.
   PubMed Web of Science ®Google Scholar
• Kilpatrick ZM, Milles SS. Achalasia in mother and daughter. Gastroenterology. 1972;62(5):1042–1046.
   PubMed Web of Science ®Google Scholar
• Monnig PJ. Familial achalasia in children. Ann Thorac Surg. 1990;49(6):1019–1022.
   PubMed Web of Science ®Google Scholar
• Eckardt VF, Aignherr C, Bernhard G. Predictors of outcome in patients with achalasia treated by pneumatic dilation. Gastroenterology. 1992 Dec;103(6):1732–1738.
   PubMed Web of Science ®Google Scholar
• Urbach DR, Tomlinson GA, Harnish JL, et al. A measure of disease-specific health-related quality of life for achalasia. Am J Gastroenterol. 2005 Aug;100(8):1668–1676.
   PubMed Web of Science ®Google Scholar
• Patel DA, Sharda R, Hovis KL, et al. Patient-reported outcome measures in dysphagia: a systematic review of instrument development and validation. Dis Esophagus. 2017 May 1 30(5):1–23.
   Web of Science ®Google Scholar
• Kostic S, Andersson M, Hellström M, et al. Timed barium esophagogram in the assessment of patients with achalasia: reproducibility and observer variation. Dis Esophagus. 2005;18(2):96–103.
   PubMed Web of Science ®Google Scholar
• Blonski W, Kumar A, Feldman J, et al. Timed barium swallow: diagnostic role and predictive value in untreated achalasia, esophagogastric junction outflow obstruction, and non-achalasia dysphagia. Am J Gastroenterol. 2018 Feb;113(2):196–203.
   PubMed Web of Science ®Google Scholar
• Rohof WO, Lei A, Boeckxstaens GE. Esophageal stasis on a timed barium esophagogram predicts recurrent symptoms in patients with long-standing achalasia. Am J Gastroenterol. 2013 Jan;108(1):49–55.
   PubMed Web of Science ®Google Scholar
• Yadlapati R, Kahrilas PJ, Fox MR, et al. Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0©. Neurogastroenterol Motil. 2021 Jan;33(1):e14058.
   PubMed Web of Science ®Google Scholar
• Zhou MJ, Kamal A, Freedberg DE, et al. Type II achalasia increasing in prevalence. Dig Dis Sci. 2020.
   Web of Science ®Google Scholar
• Hong SJ, Bhargava V, Jiang Y, et al. A unique esophageal motor pattern that involves longitudinal muscles is responsible for emptying in achalasia esophagus. Gastroenterology. 2010;139(1):102–111.
   PubMed Web of Science ®Google Scholar
• Park S, Zifan A, Kumar D, et al. Genesis of esophageal pressurization and bolus flow patterns in patients with achalasia esophagus. Gastroenterology. 2018;155(2):327–336.
   PubMed Web of Science ®Google Scholar
• Kim TH, Patel N, Ledgerwood-Lee M, et al. Esophageal contractions in type 3 achalasia esophagus: simultaneous or peristaltic? Am J Physiol Gastrointest Liver Physiol. 2016;310(9):G689–695.
   PubMed Web of Science ®Google Scholar
• Kahrilas PJ, Boeckxstaens G. The spectrum of achalasia: lessons from studies of pathophysiology and high-resolution manometry. Gastroenterology. 2013 Nov;145(5):954–965.
   PubMed Web of Science ®Google Scholar
• Ang D, Misselwitz B, Hollenstein M, et al., Diagnostic yield of high-resolution manometry with a solid test meal for clinically relevant, symptomatic oesophageal motility disorders: serial diagnostic study. Lancet Gastroenterol Hepatol. 2017;2(9):654–661. .
   PubMed Web of Science ®Google Scholar
• Woodland P, Gabieta-Sonmez S, Arguero J, et al. 200 mL rapid drink challenge during high-resolution manometry best predicts objective esophagogastric junction obstruction and correlates with symptom severity. J Neurogastroenterol Motil. 2018;24(3):410–414.
   PubMed Web of Science ®Google Scholar
• Sanagapalli S, McGuire J, Leong RW, et al. The clinical relevance of manometric esophagogastric junction outflow obstruction can be determined using rapid drink challenge and solid swallows. Am J Gastroenterol. 2021;116(2):280–288.
   PubMed Web of Science ®Google Scholar
• Savarino E, Di Pietro M, Bredenoord AJ, et al. Use of the functional lumen imaging probe in clinical esophagology. Am J Gastroenterol. 2020 Nov;115(11):1786–1796.
   PubMed Web of Science ®Google Scholar
• Carlson DA, Kahrilas PJ, Lin Z, et al. Evaluation of esophageal motility utilizing the functional lumen imaging probe. Am J Gastroenterol. 2016 Dec;111(12):1726–1735.
   PubMed Web of Science ®Google Scholar
• Carlson DA, Crowell MD, Kimmel JN, et al. Loss of peristaltic reserve, determined by multiple rapid swallows, is the most frequent esophageal motility abnormality in patients with systemic sclerosis. Clin Gastroenterol Hepatol. 2016 Oct;14(10):1502–1506.
   PubMed Web of Science ®Google Scholar
• Carlson DA, Baumann AJ, Prescott JE, et al. Prediction of esophageal retention: a study comparing high-resolution manometry and functional luminal imaging probe panometry. Am J Gastroenterol. 2021 Oct 1 116(10):2032–2041.
   PubMed Web of Science ®Google Scholar
• Carlson DA, Lin Z, Kahrilas PJ, et al. The functional lumen imaging probe detects esophageal contractility not observed with manometry in patients with achalasia. Gastroenterology. 2015 Dec;149(7):1742–1751.
   PubMed Web of Science ®Google Scholar
• Carlson DA, Gyawali CP, Khan A, et al. Classifying esophageal motility by FLIP panometry: a study of 722 subjects with manometry. Am J Gastroenterol. 2021 Dec 1 116(12):2357–2366.
   PubMed Web of Science ®Google Scholar
• Dantas RO. Management of esophageal dysphagia in chagas disease. Dysphagia. 2021 Jun;36(3):517–522.
   PubMed Web of Science ®Google Scholar
• Vicentine FP, Herbella FA, Allaix ME, et al. High-resolution manometry classifications for idiopathic achalasia in patients with Chagas’ disease esophagopathy. J Gastrointest Surg. 2014 Feb;18(2):221–224. discussion 224-5.
   PubMed Web of Science ®Google Scholar
• Vicentine FP, Herbella FA, Allaix ME, et al. Comparison of idiopathic achalasia and Chagas’ disease esophagopathy at the light of high-resolution manometry. Dis Esophagus. 2014 Feb-Mar;27(2):128–133.
   PubMed Web of Science ®Google Scholar
• Babaei A, Shad S, Massey BT. Motility patterns following esophageal pharmacologic provocation with amyl nitrite or cholecystokinin during high-resolution manometry distinguish idiopathic vs opioid-induced type 3 achalasia. Clin Gastroenterol Hepatol. 2020;18(4):813–821.e1.
   PubMed Web of Science ®Google Scholar
• Ribolsi M, Ghisa M, Savarino E. Nonachalasic esophageal motor disorders, from diagnosis to therapy. Expert Rev Gastroenterol Hepatol. 2022 Mar;16(3):205–216.
   PubMed Web of Science ®Google Scholar
• Gelfond M, Rozen P, Keren S, et al. Effect of nitrates on LOS pressure in achalasia: a potential therapeutic aid. Gut. 1981 Apr;22(4):312–318.
   PubMed Web of Science ®Google Scholar
• Coccia G, Bortolotti M, Michetti P, et al. Return of esophageal peristalsis after nifedipine therapy in patients with idiopathic esophageal achalasia. Am J Gastroenterol. 1992 Dec;87(12):1705–1708.
   PubMed Web of Science ®Google Scholar
• Coccia G, Bortolotti M, Michetti P, et al. Prospective clinical and manometric study comparing pneumatic dilatation and sublingual nifedipine in the treatment of oesophageal achalasia. Gut. 1991 Jun;32(6):604–606.
   PubMed Web of Science ®Google Scholar
• Bortolotti M, Mari C, Lopilato C, et al. Effects of sildenafil on esophageal motility of patients with idiopathic achalasia. Gastroenterology. 2000 Feb;118(2):253–257.
   PubMed Web of Science ®Google Scholar
• Bassotti G, Annese V. Review article: pharmacological options in achalasia. Aliment Pharmacol Ther. 1999 Nov;13(11):1391–1396.
   PubMed Web of Science ®Google Scholar
• Annese V, Bassotti G, Coccia G, et al., A multicentre randomised study of intrasphincteric botulinum toxin in patients with oesophageal achalasia. GISMAD Achalasia Study Group. Gut. 2000;46(5): 597–600. .
   PubMed Web of Science ®Google Scholar
• Patti MG, Feo CV, Arcerito M, et al. Effects of previous treatment on results of laparoscopic Heller myotomy for achalasia. Digestive Dis Sci. 1999;44(11):2270–2276.
   PubMed Web of Science ®Google Scholar
• Horgan S, Hudda K, Eubanks T, et al. Does botulinum toxin injection make esophagomyotomy a more difficult operation? Surg Endosc. 1999;13(6):576–579.
   PubMed Web of Science ®Google Scholar
• Smith CD, Stival A, Howell DL, et al. Endoscopic therapy for achalasia before Heller myotomy results in worse outcomes than heller myotomy alone. Ann Surg. 2006;243(5):579–584. discussion 584–586.
   PubMed Web of Science ®Google Scholar
• Kumar AR, Schnoll-Sussman FH, Katz PO. Botulinum toxin and pneumatic dilation in the treatment of achalasia. Tech. Gastrointest. Endosc. 2014;16(1):10–19.
   Google Scholar
• Vaezi MF, Richter JE, Wilcox CM, et al. Botulinum toxin versus pneumatic dilatation in the treatment of achalasia: a randomised trial. Gut. 1999;44(2):231–239.
   PubMed Web of Science ®Google Scholar
• Pasricha PJ, Rai R, Ravich WJ, et al., Botulinum toxin for achalasia: long-term outcome and predictors of response. Gastroenterology. 1996;110(5): 1410–1415. .
   PubMed Web of Science ®Google Scholar
• van Hoeij FB, Prins LI, Smout AJPM, et al. Efficacy and safety of pneumatic dilation in achalasia: a systematic review and meta-analysis. Neurogastroenterol Motil. 2019 Jul;31(7):e13548.
   PubMed Web of Science ®Google Scholar
• Müller M, Keck C, Eckardt AJ, et al. Outcomes of pneumatic dilation in achalasia: extended follow-up of more than 25 years with a focus on manometric subtypes. J Gastroenterol Hepatol. 2018 May;33(5):1067–1074.
   PubMed Web of Science ®Google Scholar
• Pratap N, Kalapala R, Darisetty S, et al. Achalasia cardia subtyping by high-resolution manometry predicts the therapeutic outcome of pneumatic balloon dilatation. J Neurogastroenterol Motil. 2011 Jan;17(1):48–53.
   PubMed Web of Science ®Google Scholar
• Rohof WO, Salvador R, Annese V, et al. Outcomes of treatment for achalasia depend on manometric subtype. Gastroenterology. 2013 Apr;144(4):718–725.
   PubMed Web of Science ®Google Scholar
• Torresan F, Cortellini F, Azzaroli F, et al. Graded pneumatic dilation in subtype I and II achalasia: long-term experience in a single center. Ann Gastroenterol. 2022;35(1):28–33.
   PubMed Web of Science ®Google Scholar
• Boeckxstaens GE, Annese V, Bruley Des Varannes S, et al. Pneumatic dilation versus laparoscopic Heller’s myotomy for idiopathic achalasia. N Engl J Med. 2011 May 12;364(19):1807–1816.
   PubMed Web of Science ®Google Scholar
• Moonen A, Annese V, Belmans A, et al. Long-term results of the European achalasia trial: a multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy. Gut. 2016;65(5):732–739.
   PubMed Web of Science ®Google Scholar
• Ghoshal UC, Kumar S, Saraswat VA, et al. Long-term follow-up after pneumatic dilation for achalasia cardia: factors associated with treatment failure and recurrence. Am J Gastroenterol. 2004 Dec;99(12):2304–2310.
   PubMed Web of Science ®Google Scholar
• Farhoomand K, Connor JT, Richter JE, et al. Predictors of outcome of pneumatic dilation in achalasia. Clin Gastroenterol Hepatol. 2004 May;2(5):389–394.
   PubMed Web of Science ®Google Scholar
• Guardino JM, Vela MF, Connor JT, et al. Pneumatic dilation for the treatment of achalasia in untreated patients and patients with failed Heller myotomy. J Clin Gastroenterol. Nov-Dec. 2004;38(10):855–860.
   PubMed Web of Science ®Google Scholar
• Schnurre L, Murray FR, Schindler V, et al. Short-term outcome after singular hydraulic EsoFLIP dilation in patients with achalasia: a feasibility study. Neurogastroenterol Motil. 2020 Sep;32(9):e13864.
   PubMed Web of Science ®Google Scholar
• Mundre P, Black CJ, Mohammed N, et al. Efficacy of surgical or endoscopic treatment of idiopathic achalasia: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2021 Jan;6(1):30–38.
   PubMed Web of Science ®Google Scholar
• Ortega JA, Madureri V, Perez L. Endoscopic myotomy in the treatment of achalasia. Gastrointest Endosc. 1980 Feb;26(1):8–10.
   PubMed Web of Science ®Google Scholar
• Pasricha PJ, Hawari R, Ahmed I, et al. Submucosal endoscopic esophageal myotomy: a novel experimental approach for the treatment of achalasia. Endoscopy. 2007 Sep;39(9):761–764.
   PubMed Web of Science ®Google Scholar
• Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010 Apr;42(4):265–271.
   PubMed Web of Science ®Google Scholar
• Evensen H, Kristensen V, Larssen L, et al. Outcome of peroral endoscopic myotomy (POEM) in treatment-naive patients. A systematic review. Scand J Gastroenterol. 2019 Jan;54(1):1–7.
   PubMed Web of Science ®Google Scholar
• Inoue H, Sato H, Ikeda H, et al. Per-Oral Endoscopic Myotomy: a series of 500 patients. J Am Coll Surg. 2015 Aug;221(2):256–264.
   PubMed Web of Science ®Google Scholar
• Sudarshan M, Raja S, Adhikari S, et al. Peroral endoscopic myotomy provides effective palliation in type III achalasia. J Thorac Cardiovasc Surg. 2022 Feb;163(2):512–519.e1.
   PubMed Web of Science ®Google Scholar
• Talukdar R, Inoue H, Nageshwar D. Reddy efficacy of peroral endoscopic myotomy (POEM) in the treatment of achalasia: a systematic review and meta-analysis. Surg Endosc. Nov;29(11):3030–3046.
   PubMed Web of Science ®Google Scholar
• Schlottmann F, Luckett DJ, Fine J, et al. Laparoscopic Heller Myotomy Versus Peroral Endoscopic Myotomy (POEM) for achalasia: a systematic review and meta-analysis. Ann Surg. 2018 Mar;267(3):451–460.
   PubMed Web of Science ®Google Scholar
• Costantini A, Familiari P, Costantini M, et al. Poem versus laparoscopic Heller myotomy in the treatment of esophageal achalasia: a case-control study from two high volume centers using the propensity score. J Gastrointest Surg. 2020 Mar;24(3):505–515.
   PubMed Web of Science ®Google Scholar
• Werner YB, Hakanson B, Martinek J, et al. Endoscopic or surgical myotomy in patients with idiopathic achalasia. N Engl J Med. 2019 Dec 5 381(23):2219–2229.
   PubMed Web of Science ®Google Scholar
• Ponds FA, Fockens P, Lei A, et al. Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia: a randomized clinical trial. JAMA. 2019 Jul 9 322(2):134–144.
   PubMed Web of Science ®Google Scholar
• Shiwaku H, Sato H, Shimamura Y, et al. Risk factors and long-term course of gastroesophageal reflux disease after peroral endoscopic myotomy: a large-scale multicenter cohort study in Japan. Endoscopy. 2022;54(9):839–847 .
   Web of Science ®Google Scholar
• McKay SC, Dunst CM, Ahmed M, et al. POEM: clinical outcomes beyond 5 years. Surg Endosc. 2021 Oct;35(10):5709–5716.
   PubMed Web of Science ®Google Scholar
• Lois AW, Oelschlager BK, Wright AS, et al. Use and safety of Per-Oral Endoscopic Myotomy for achalasia in the US. JAMA Surg. 2022 Jun 1 157(6):490–497.
   PubMed Web of Science ®Google Scholar
• Youssef Y, Richards WO, Sharp K, et al. Relief of dysphagia after laparoscopic Heller myotomy improves long-term quality of life. J Gastrointest Surg. 2007;11(3):309–313.
   PubMed Web of Science ®Google Scholar
• Donahue PE, Horgan S, Liu KJ, et al. Floppy dor fundoplication after esophagocardiomyotomy for achalasia. Surgery. 2002;132(4):716–722. discussion 722-713.
   PubMed Web of Science ®Google Scholar
• Lynch KL, Pandolfino JE, Howden CW, et al. Major complications of pneumatic dilation and Heller myotomy for achalasia: single-center experience and systematic review of the literature. Am J Gastroenterol. 2012;107(12):1817–1825.
   PubMed Web of Science ®Google Scholar
• Zaninotto G, Costantini M, Rizzetto C, et al. Four hundred laparoscopic myotomies for esophageal achalasia: a single Centre experience. Ann Surg. 2008;248(6):986–993.
   PubMed Web of Science ®Google Scholar
• Kumbhari V, Tieu A, Onimaru M, et al. Peroral endoscopic myotomy (POEM) vs laparoscopic Heller myotomy (LHM) for the treatment of type III achalasia in 75 patients: a multicenter comparative study. Endosc Int Open. 2015;3(3):E195–E201.
   PubMed Web of Science ®Google Scholar
• Schuchert MJ, Luketich JD, Landreneau RJ, et al. Minimally invasive surgical treatment of sigmoidal esophagus in achalasia. J Gastrointest Surg. 2009;13(6):1029–1035. discussion 1035-1026.
   PubMed Web of Science ®Google Scholar
• Robert M, Poncet G, Mion F, et al. Results of laparoscopic Heller myotomy without anti-reflux procedure in achalasia. Monocentric prospective study of 106 cases. Surg Endosc. 2008;22(4):866–874.
   PubMed Web of Science ®Google Scholar
• Campos GM, Vittinghoff E, Rabl C, et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg. 2009;249(1):45–57.
   PubMed Web of Science ®Google Scholar
• Gouda BP, Nelson T, Bhoyrul S. Revisional surgery after heller myotomy for treatment of achalasia: a comparative analysis focusing on operative approach. Indian J Surg. 2012;74(4):309–313.
   PubMed Web of Science ®Google Scholar
• Di Martino N, Monaco L, Izzo G, et al. The effect of esophageal myotomy and myectomy on the lower esophageal sphincter pressure profile: intraoperative computerized manometry study. Dis Esophagus. 2005;18(3):160–165.
   PubMed Web of Science ®Google Scholar
• Zaninotto G, Annese V, Costantini M, et al. Randomized controlled trial of botulinum toxin versus laparoscopic heller myotomy for esophageal achalasia. Ann Surg. 2004 Mar;239(3):364–370.
   PubMed Web of Science ®Google Scholar
• Wu PI, Szczesniak MM, Craig PI, et al. Novel intra-procedural distensibility measurement accurately predicts immediate outcome of pneumatic dilatation for idiopathic achalasia. Am J Gastroenterol. 2018 Feb;113(2):205–212.
   PubMed Web of Science ®Google Scholar
• Campagna RAJ, Carlson DA, Hungness ES, et al. Intraoperative assessment of esophageal motility using FLIP during myotomy for achalasia. Surg Endosc. 2020 Jun;34(6):2593–2600.
   PubMed Web of Science ®Google Scholar
• Holmstrom AL, Campagna RJ, Carlson DA, et al. Comparison of preoperative, intraoperative, and follow-up functional luminal imaging probe measurements in patients undergoing myotomy for achalasia. Gastrointest Endosc. 2021 Sep;94(3):509–514.
   PubMed Web of Science ®Google Scholar
• Kappelle WF, Bogte A, Siersema PD. Hydraulic dilation with a shape-measuring balloon in idiopathic achalasia: a feasibility study. Endoscopy. 2015;47(11):1028–1034.
   PubMed Web of Science ®Google Scholar
• Visaggi P, de Bortoli N, Barberio B, et al. Artificial intelligence in the diagnosis of upper gastrointestinal diseases. J Clin Gastroenterol. 2022 Jan 1 56(1):23–35.
   PubMed Web of Science ®Google Scholar
• Sinonquel P, Bisschops R. Striving for quality improvement: can artificial intelligence help? Best Pract Res Clin Gastroenterol. 2021 Jun-Aug;52-53:101722.
   PubMed Web of Science ®Google Scholar
• Tokat M, van Tilburg L, Koch AD, et al. Artificial intelligence in upper gastrointestinal endoscopy. Dig Dis. 2022;40(4):395–408.
   PubMed Web of Science ®Google Scholar
• Kröner PT, Engels MM, Glicksberg BS, et al. Artificial intelligence in gastroenterology: a state-of-the-art review. World J Gastroenterol. 2021 Oct 28 27(40):6794–6824.
   PubMed Web of Science ®Google Scholar