ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2014
Laparoscopic Heller myotomy can be used as primary therapy for esophageal achalasia regardless of age.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 40 citations in OpenAlex.
- Intraoperative indocyanine green (ICG) fluorescence to assess mucosal integrity during laparoscopic Heller-Dor surgery: a pilot randomized study.Updates in surgery · 2026Article
- Achalasia in Geriatric Patients: A Comprehensive Overview.Digestive diseases and sciences · 2026Review
- Re-operation after prior esophagomyotomy.Journal of visualized surgery · 2024Article
- Article
- Achalasia in the Elderly: Diagnostic Approach and a Proposed Treatment Algorithm Based on a Comprehensive Literature Review.Journal of clinical medicine · 2021Review
- Peroral endoscopic myotomy is a safe and effective treatment modality for geriatric patients with achalasia.Esophagus : official journal of the Japan Esophageal Society · 2020Article
- Doing more with less: our decade of experience with laparo-endoscopic single site Heller myotomy supports its application.Surgical endoscopy · 2020Article
- Laparoscopic repair of late perforation following Heller myotomy due to overeating.Annals of the Royal College of Surgeons of England · 2020Article
- 2019 Seoul Consensus on Esophageal Achalasia Guidelines.Journal of neurogastroenterology and motility · 2020Review
- 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
- Dysphagia in the Elderly.Current treatment options in gastroenterology · 2017Review
- Effects of laparoscopic myotomy on the esophageal motility pattern of esophageal achalasia as measured by high-resolution manometry.Surgical endoscopy · 2017Observational
- Postoperative Gastroesophageal Reflux After Laparoscopic Heller-Dor for Achalasia: True Incidence with an Objective Evaluation.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 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
- Achalasia: A case report on its effect during surgical decision making for laparoscopic sleeve gastrectomy in the young morbidly obese patient.International journal of surgery case reports · 2016Article
- The Impact of Heller Myotomy on Integrated Relaxation Pressure in Esophageal Achalasia.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2016Article
- Laparoscopic Heller myotomy for achalasia: does the age of the patient affect the outcome?World journal of surgery · 2015Review
- Therapeutic options in oesophageal dysphagia.Nature reviews. Gastroenterology & hepatology · 2015Review
- Controversies in management of achalasia.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2014Review
- Childhood achalasia: A comprehensive review of disease, diagnosis and therapeutic management.World journal of gastrointestinal endoscopy · 2014Review
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLaparoscopic Heller-Dor surgery is the current treatment of choice for patients with esophageal achalasia, but elderly patients are generally referred for less invasive treatments (pneumatic dilations or botulinum toxin injections).
aimTo assess the effect of age on the surgical outcome of patients receiving laparoscopic Heller-Dor as primary treatment.
methodsDemographic and clinical findings were prospectively collected on patients undergoing laparoscopic Heller-Dor from 1992 to 2012. Patients were classified in three age brackets: group A (≤45 years), group B (45-70), and group C (≥70). Treatment was defined as a failure if the postoperative symptom score was >10th percentile of the preoperative score (i.e., >8). We consecutively performed the Heller-Dor in 571 achalasia patients, 305 (53.4 %) in group A, 226 (39.6 %) in group B, and 40 (7 %) in group C.
resultsThe mortality was nil; the conversion and morbidity rates were both 1.1 %. Group C patients had higher preoperative symptom scores (p = 0.02), while the symptom duration was similar in all three groups. Mucosal tears occurred in 17 patients (3 %): 6 (2 %) in group A, 8 (3.5 %) in group B, and 3 (7.5 %) in group C (p = 0.09). The postoperative hospital stay was slightly longer for group C (p = 0.06). DISCUSSION: The treatment failure rate was quite similar: 31 failures in group A (10.1 %), 19 in group B (8.4 %), and 3 in group C (7.5 %; p = 0.80). These failures were seen more in manometric pattern III (22.2 %, p = 0.002). Laparoscopic Heller-Dor can be used as the first therapeutic approach to achalasia even in elderly patients with an acceptable surgical risk.
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