ArticleSurgical endoscopy2015
High resolution manometry sub-classification of Achalasia: does it really matter? Does Achalasia sub-classification matter?
Article in Surgical endoscopy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 4 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Clinical characteristics and manometric findings of esophageal achalasia-a systematic review regarding differences among three subtypes.Journal of smooth muscle research = Nihon Heikatsukin Gakkai kikanshi · 2023Pooled it
- Risk factors for gastroesophageal reflux after POEM for achalasia: a systematic review and meta-analysis.Surgical endoscopy · 2021Pooled it
- ACG Clinical Guidelines: Diagnosis and Management of Achalasia.The American journal of gastroenterology · 2020Guideline
- Guideline
- Myotomy length informed by high-resolution esophageal manometry (HREM) results in improved per-oral endoscopic myotomy (POEM) outcomes for type III achalasia.Surgical endoscopy · 2019Article
- Long-Term Efficacy of Peroral Endoscopic Myotomy for Patients with Achalasia: Outcomes with a Median Follow-Up of 36 Months.Digestive diseases and sciences · 2019Article
- The relationship between manometric subtype and outcomes of surgical treatment for patients with achalasia : Achalasia: manometric subtypes.Surgical endoscopy · 2017Article
- Per-oral endoscopic myotomy for achalasia.Journal of thoracic disease · 2017Review
- Achalasia symptom response after Heller myotomy segregated by high-resolution manometry subtypes.Journal of gastroenterology · 2016Observational
- Peroral endoscopic myotomy.World journal of gastrointestinal endoscopy · 2015Review
- Optimizing Patient Selection and Outcomes for Surgical Treatment of GERD and Achalasia.Current treatment options in gastroenterology · 2015Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThree variants of Achalasia have been described using high-resolution esophageal manometry (HRM). While manometrically distinct, their clinical significance has yet to be established. Our objective was to compare the outcome after myotomy in patients with these Achalasia subtypes.
methodsA retrospective chart review was performed to identify patients with Achalasia who had HRM and who underwent Heller myotomy or Per oral endoscopic myotomy (POEM). Symptoms and esophageal clearance by timed barium study were compared before and after treatment.
resultsWe identified 49 patients, 21 males and 28 females, with a median age of 52 years. The primary symptom in all patients was dysphagia, with a median duration of 4 years (range 4 months-50 years). By HRM, ten patients (20 %) were classified as Type I, 30 (61 %) as Type II, and 9 (18 %) as Type III. At a median follow-up of 16 months after myotomy (range 1-63 months), the median Eckardt score was zero and was similar across subtypes. Relief of dysphagia was also similar across subtypes (80 % of Type I, 93 % of Type II and 89 % of Type III). On pre-treatment timed barium study, no patient had complete emptying at 1 or 5 min. After myotomy, complete emptying occurred within 1 min in 50 % (20/40) and within 5 min in 60 % (24/40) and was similar across groups.
conclusionMyotomy for Achalasia results in excellent symptomatic outcome and improvement in esophageal clearance. There was no difference among the described HRM Achalasia variants. This calls into question the clinical utility of Achalasia sub-classification and affirms the benefit of myotomy for this disease.
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