ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2005
Long-term outcome of laparoscopic Heller-Dor surgery for esophageal achalasia: possible detrimental role of previous endoscopic treatment.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.
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Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it, 106 citations in OpenAlex.
- Major complications of pneumatic dilation and Heller myotomy for achalasia: single-center experience and systematic review of the literature.The American journal of gastroenterology · 2012Pooled it
- Trial
- Significance of limited hiatal dissection in surgery for achalasia.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2010Trial
- Laparoscopic Heller-Dor as salvage therapy after failed POEM: a prospective comparative study.Surgical endoscopy · 2026Article
- Heller myotomy in patients with prior endoscopic interventions vs the treatment-naïve.Surgical endoscopy · 2025Article
- Pre-operative endoscopic balloon dilatation and its impact on outcome of laparoscopic Heller cardiomyotomy for patients with achalasia: does the frequency and interval matter?Surgical endoscopy · 2023Article
- Long-term Efficacy of Combined Treatment in Patients with Idiopathic Achalasia.Middle East journal of digestive diseases · 2021Article
- A Thousand and One Laparoscopic Heller Myotomies for Esophageal Achalasia: a 25-Year Experience at a Single Tertiary Center.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
- Effects of laparoscopic myotomy on the esophageal motility pattern of esophageal achalasia as measured by high-resolution manometry.Surgical endoscopy · 2017Observational
- Long-term outcomes of Heller's myotomy and balloon dilatation in childhood achalasia.European journal of pediatrics · 2017Article
- Impact of prior interventions on outcomes during per oral endoscopic myotomy.Surgical endoscopy · 2017Article
- [Surgical treatment of achalasia - endoscopic or laparoscopic? : Proposal for a tailored approach].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2017Article
- Mucosal Perforation During Laparoscopic Heller Myotomy Has No Influence on Final Treatment Outcome.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2016Article
- Laparoscopic esophagomyotomy for achalasia in children: A review.World journal of gastrointestinal endoscopy · 2016Review
- Endoscopic treatment of esophageal achalasia.World journal of gastrointestinal endoscopy · 2016Article
- Therapeutic options in oesophageal dysphagia.Nature reviews. Gastroenterology & hepatology · 2015Review
- [Diagnostics and therapy of achalasia].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2014Review
- Analysis of a learning curve and predictors of intraoperative difficulty for peroral esophageal myotomy (POEM).Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2014Article
- Current status in the treatment options for esophageal achalasia.World journal of gastroenterology · 2013Review
- Peroral endoscopic myotomy (POEM) is safe and effective in the setting of prior endoscopic intervention.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2013Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Laparoscopic Heller myotomy has recently emerged as the treatment of choice for esophageal achalasia. Previous unsuccessful treatments (pneumatic dilations or botulinum toxin [BT] injections) can make surgery more difficult, causing a higher risk of mucosal perforation and jeopardizing the outcome. The study goal was to evaluate the effects of prior endoscopic treatments on laparoscopic Heller myotomy. Between January 1992 and February 2005, 248 patients (130 males and 118 females; median age, 43 years) underwent a laparoscopic Heller-Dor operation for achalasia: 203 underwent primary surgery (group A), 19 had been previously treated with pneumatic dilations (group B), and 26 had BT injections (alone [22] or with dilations [4] (group C)). Median duration of the operation and rate of intraoperative mucosal lesions were not different in the three groups. Median follow-up was 41 months. The 5-year actuarial of control of dysphagia was similar in groups A (86%) and B (94%), whereas only 75% of group C patients were symptom free at 5 years (P = 0.02). On logistic regression analysis, prior treatment with two BT injections or BT combined with dilation was associated with poor outcome of surgery. Further, dilations for surgical failure patients were effective in 80% of group A but in only 33% of group B or C patients. Heller-Dor surgery is safe and effective as a primary or a second-line treatment (after pneumatic dilations or BT injections) for achalasia. However, long-term results seem less satisfactory in patients previously treated with BT.
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