ArticleSurgical endoscopy2015
National outcomes of laparoscopic Heller myotomy: operative complications and risk factors for adverse events.
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 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Robotic versus laparoscopic heller myotomy for esophageal achalasia: an updated systematic review and meta-analysis.Langenbeck's archives of surgery · 2025Pooled it
- 30-day outcomes of robotic versus laparoscopic Heller myotomy.Surgical endoscopy · 2025Article
- Periprocedural safety profile of peroral endoscopic myotomy (POEM)-a retrospective analysis of adverse events according to two different classifications.Surgical endoscopy · 2023Article
- PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2023Observational
- POEM, GPOEM, and ZPOEM.Digestive diseases and sciences · 2022Review
- Non-elective paraesophageal hernia repair: surgical approaches and short-term outcomes.Surgical endoscopy · 2021Article
- Intraoperative Esophagogastroduodenoscopy During Heller Myotomy: Evaluating Guidelines.World journal of surgery · 2021Article
- Association of the Risk of a Venous Thromboembolic Event in Emergency vs Elective General Surgery.JAMA surgery · 2020Article
- Use of minimally invasive surgery in emergency general surgery procedures.Surgical endoscopy · 2020Article
- 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
- Surgery for benign esophageal disorders in the US: risk factors for complications and trends of morbidity.Surgical endoscopy · 2018Article
- Achalasia Patients Are at Nutritional Risk Regardless of Presenting Weight Category.Digestive diseases and sciences · 2018Article
- Per-oral endoscopic myotomy (POEM): mid-term efficacy and safety.Surgical endoscopy · 2018Article
- Laparoscopic versus open peritoneal dialysis catheter placement.Surgical endoscopy · 2016Article
- Nationwide variation in outcomes and cost of laparoscopic procedures.Surgical endoscopy · 2016Article
- Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients.Surgical endoscopy · 2016Article
- Submucosal tunnel endoscopy: Peroral endoscopic myotomy and peroral endoscopic tumor resection.World journal of gastrointestinal endoscopy · 2016Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLaparoscopic Heller myotomy (LHM) has supplanted an open approach due to decreased operative morbidity. Our goal was to quantify the incidence of peri-operative complications and identify risk factors for adverse outcomes in LHM.
methodsAll LHM were queried from 2005 to 2011 from the National Surgical Quality Improvement Program database. Adverse outcomes were identified, and univariate and stepwise logistic regression (MVR) was then performed to quantify association.
resultsThere were 1,237 LHM in the study period. Patient averages were: age 51.9 ± 16.8 years, BMI 27.3 ± 6.6 kg/m(2), Charlson comorbidity index (CCI) 0.2 ± 0.6. 15.3 % had >10 % body mass loss in the preoperative 6 months. During surgery, 10.2 % underwent concomitant EGD, and mean operative time was 141.6 ± 63.4 min. There were 7(0.06 %) wound complications, 22(1.8 %) general complications, and 30(2.4 %) major complications. Average length of stay (LOS) was 2.8 ± 5.5 days. The rate of readmission and reoperation were 3.1 and 2.3 %, respectively, and there were 4(0.03 %) deaths. General and major complications were associated with alcohol use, pack-years of smoking, weight loss, history of stroke, radiation therapy, and longer operative times (p < 0.05); however, these factors did not remain significant on MVR (p > 0.05). Operative time was found to be significantly longer by 35.3 min for inpatients, 43.1 min in functionally dependent patients, 50.0 min in preoperative septic patients, and 17.2 min with concomitant EGD (p < 0.01 for all). LOS was found to be longer by 1.9 days for inpatients, 1.8 days in ASA category ≥3, and 1.2 days per one point increase in CCI (p < 0.001 for all).
conclusionLHM is being performed nationally with a low incidence of operative complications and mortality. General and major complications following LHM are associated with patient alcohol use, pack-years of smoking, weight loss, history of stroke, radiation therapy, and longer operative times. Additionally, independent predictors of longer operative time and LOS were identified.
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