SynthesisMedicine2017
Laparoscopic Heller myotomy is not superior to pneumatic dilation in the management of primary achalasia: Conclusions of a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 5 of them syntheses that pooled it.
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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
16 citing papers in PubMed, 5 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Comprehensive evaluation of current strategies in achalasia treatment: Insights from an umbrella review.Medicine · 2025Pooled it
- Efficacy and safety of laparoscopic Heller's myotomy versus pneumatic dilatation for achalasia: A systematic review and meta-analysis of randomized controlled trials.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Pooled it
- 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
- Pneumatic balloon dilatation versus laparoscopic Heller myotomy for achalasia: a failed attempt at meta-analysis.Surgical endoscopy · 2021Pooled it
- ACG Clinical Guidelines: Diagnosis and Management of Achalasia.The American journal of gastroenterology · 2020Guideline
- Laparoscopic Heller myotomy or pneumatic dilatation in achalasia: results of a prospective, randomized study with at least a decade of follow-up.Surgical endoscopy · 2021Trial
- Problems with repairing gut sphincters malfunctions.World journal of gastrointestinal surgery · 2024Article
- What role does the submucosa play in the pathophysiology and treatment of achalasia? An analysis of impedance planimetry during POEM.Surgical endoscopy · 2023Article
- Pneumatic Dilation in Geriatric Achalasia Patients.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Article
- Per-oral endoscopic myotomy for the treatment of non-achalasia esophageal dysmotility disorders: experience from a single high-volume center.Surgical endoscopy · 2023Article
- Peroral endoscopic myotomy (POEM) vs pneumatic dilation (PD) in treatment of achalasia: A meta-analysis of studies with ≥ 12-month follow-up.Endoscopy international open · 2021Article
- Heller myotomy is the optimal index procedure for esophageal achalasia in adolescents and young adults.Surgical endoscopy · 2019Article
- Management of Esophageal Achalasia in Quebec.Journal of clinical medicine research · 2019Article
- The treatment of achalasia patients with esophageal varices: an international study.United European gastroenterology journal · 2019Article
- Effects of preoperative endoscopic pneumatic balloon dilatation on postoperative achalasia symptoms after Heller esophageal myotomy plus Dor fundoplication.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2018Article
- Editorial: Assessing Esophageal Function in Achalasia: The Old and the New.The American journal of gastroenterology · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAchalasia is an esophageal motility disorder, of unknown cause, which results in increased lower esophageal sphincter tone and symptoms of difficulty swallowing. Current major therapeutic options include laparoscopic Heller myotomy (LHM) and pneumatic dilation (PD). We undertake a systematic review comparing the efficacy and safety of these 2 treatments in the treatment of esophageal achalasia.
methodsPubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trial investigating LHM versus PD in the treatment of primary achalasia. The primary outcome was symptom remission rates. The Mantel-Haenszel method with fixed-effect or random-effects model was used to calculate relative risks and 95% confidence intervals (CIs).
resultsFive studies involving 498 participants were included. The cumulative remission rate was significantly higher with LHM at 3 months and 1 year (short-term), with a risk ratio of 1.16 (95% CI 1.01-1.35, P = 0.04) and 1.14 (95% CI 1.02-1.27, P = 0.02), respectively. There were no significant differences between LHM and PD in 2-year and 5-year remission rate (long-term), with a risk ratio of 1.05 (95% CI 0.91-1.22, P = 0.49) and 1.17 (95% CI 0.84-1.64, P = 0.34), respectively. Rates of major mucosal tears requiring subsequent intervention with LHM were significantly lower than those of esophageal perforation with PD requiring postprocedural medical or surgical therapy, with a risk ratio of 0.25 (95% CI 0.08-0.81, P = 0.02). Postprocedural rates of gastroesophageal reflux, lower esophageal sphincter pressures, and quality of life scores did not differ in trials with sufficient data.
conclusionsThere were no significant differences between LHM and PD in 2-year and 5-year remission rate. This study indicates that either treatment can be proposed as initial treatment for achalasia.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.