Publication Name	World Journal of Gastroenterology
Manuscript ID	119182
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Correspondence
Article Title	Letter to the Editor: To cut or not to cut-objective metrics in achalasia with septum-less diverticulum
Manuscript Source	Invited Manuscript
All Author List	Xin-Meng Li, Yong-Rui Tao, Fan-Chun Zeng and Yuan Chen
Funding Agency and Grant Number
Corresponding Author	Yuan Chen, PhD, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen 518060, Guangdong Province, China. chenyuanx2000@163.com
Key Words	Achalasia; Esophageal diverticulum; Per-oral endoscopic myotomy; Blown-out myotomy; Digestive endoscopic tunnel technique
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.
Citation	Li XM, Tao YR, Zeng FC, Chen Y. Letter to the Editor: To cut or not to cut-objective metrics in achalasia with septum-less diverticulum. World J Gastroenterol 2026; In press

Received	2026-01-21 05:40
Peer-Review Started	2026-01-21 05:41
First Decision by Editorial Office Director	2026-02-27 09:03
Return for Revision	2026-02-27 09:03
Revised	2026-03-25 08:16
Publication Fee Transferred
Second Decision by Editor	2026-04-23 02:38
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-23 04:18
Articles in Press	2026-04-23 04:18
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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