ArticleSurgical endoscopy2017
The relationship between manometric subtype and outcomes of surgical treatment for patients with achalasia : Achalasia: manometric subtypes.
Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 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
- ACG Clinical Guidelines: Diagnosis and Management of Achalasia.The American journal of gastroenterology · 2020Guideline
- The interplay between alterations in esophageal microbiota associated with Th17 immune response and impaired LC20 phosphorylation in achalasia.Journal of gastroenterology · 2024Article
- Influence of Achalasia on the Spirometry Flow-Volume Curve and Peak Expiratory Flow.Diagnostics (Basel, Switzerland) · 2024Article
- Characteristics of achalasia and detection of pulmonary complications: A comparison of findings in younger and elderly patients.Qatar medical journal · 2024Article
- Achalasia Subtype Differences Based on Respiratory Symptoms and Radiographic Findings.Diagnostics (Basel, Switzerland) · 2023Article
- Long-term (17 years) subjective and objective evaluation of the durability of laparoscopic Heller esophagomyotomy in patients with achalasia of the esophagus (90% of follow-up): a real challenge to POEM.Surgical endoscopy · 2022Article
- 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
- Value of Multidetector Computed Tomography in the Assessment of Achalasia Subtypes and Detection of Pulmonary and Thoracic Complications.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2019Article
- 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
- The Esophageal Manometry with Gas-perfused Catheters.Open medicine (Warsaw, Poland) · 2018Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Chicago Classification describes three distinct subtypes of achalasia and it appears to be a promising tool in predicting results of treatment with standard Heller Myotomy. The aim of this study is to analyze the outcomes of surgical treatment for achalasia using an extended Heller myotomy for each subtype and to identify additional parameters that may predict the success of therapy.
methods72 consecutive patients with achalasia were evaluated at the University of Washington between 2008 and 2013. Symptom duration, patient age, and the degree of esophageal dilation (stage 1-3) as assessed by radiography were determined. We defined treatment failure as no improvement in symptoms and/or need for a second therapy within 1 year. Long-term follow-up data of 25 patients were available in the form of a survey evaluating overall satisfaction with the operation.
resultsThe distribution of patients according to subtype included 13 with type I, 54 with type II, and 5 with type III. All of the type I patients had some degree of esophageal dilation on radiography, whereas no dilation was found in the type III group. All patients underwent uneventful laparoscopic-extended Heller myotomy. Two patients were classified as failures, including one with type I and one with type II achalasia; however, further investigation revealed the cause of both failures to be the development of peptic stricture. Only one of the 25 patients with long-term follow-up reported dissatisfaction with the treatment result and indicated persistent chest pain without dysphagia.
conclusionsLaparoscopic-extended Heller myotomy is a highly successful treatment for patients with achalasia and outcomes do not appear to vary significantly according to the manometric subtype. Failures may result from reflux in patients who develop esophagitis or stricture. Chest pain is not always responsive to esophagogastric myotomy despite relief of dysphagia.
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