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World J Gastroenterol. Sep 14, 2026; 32(34): 119182
Published online Sep 14, 2026. doi: 10.3748/wjg.119182
Published online Sep 14, 2026. doi: 10.3748/wjg.119182
Letter to the Editor: To cut or not to cut-objective metrics in achalasia with septum-less diverticulum
Xin-Meng Li, Department of Neurosurgery, Yantian District People’s Hospital, Shenzhen 518081, Guangdong Province, China
Yong-Rui Tao, Fan-Chun Zeng, Shenzhen University, Shenzhen 518000, Guangdong Province, China
Yuan Chen, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, Guangdong Province, China
Co-first authors: Xin-Meng Li and Yong-Rui Tao.
Co-corresponding authors: Fan-Chun Zeng and Yuan Chen.
Author contributions: Chen Y designed the research; Li XM and Tao YR wrote the original draft of the manuscript; Zeng FC and Chen Y critically revised and polished the manuscript; Li XM and Tao YR contributed equally to this work and should be considered co-first authors; Zeng FC and Chen Y contributed equally as corresponding authors; all authors discussed the results, reviewed the manuscript, and approved the final version for publication.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Yuan Chen, PhD, Doctor, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen 518060, Guangdong Province, China. chenyuanx2000@163.com
Received: January 21, 2026
Revised: March 25, 2026
Accepted: April 23, 2026
Published online: September 14, 2026
Processing time: 210 Days and 11.4 Hours
Revised: March 25, 2026
Accepted: April 23, 2026
Published online: September 14, 2026
Processing time: 210 Days and 11.4 Hours
Core Tip
Core Tip: We critically appraise the phenotypic classification proposed by Hao et al, contending that the entity termed “diverticulum without septum” most plausibly represents an iatrogenic blown-out myotomy, given the high prevalence of prior endoscopic interventions in this cohort. Furthermore, we question the asserted necessity of septotomy, as recent multicenter evidence suggests standard myotomy alone is equally effective for epiphrenic diverticula, while mitigating the additional procedural risks. Distinguishing between primary pathology and secondary adverse events, paired with objective functional follow-up, is crucial for selecting the appropriate endoscopic strategy.