ArticleSurgical endoscopy2018
Per oral endoscopic myotomy vs. laparoscopic Heller myotomy, does gastric extension length matter?
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 5 of them syntheses 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.
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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
18 citing papers in PubMed, 5 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Short Versus Standard Peroral Endoscopic Myotomy for Esophageal Achalasia: A Meta-Analysis of Randomized Controlled Trials.Digestive diseases and sciences · 2025Pooled it
- Achalasia: laparoscopic Heller myotomy with fundoplication versus peroral endoscopic myotomy-a systematic review and meta-analysis.Esophagus : official journal of the Japan Esophageal Society · 2024Pooled it
- Peroral endoscopic myotomy compared to laparoscopic Heller myotomy and pneumatic dilation in the treatment of achalasia: a systematic review.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2024Pooled it
- Is peroral endoscopic myotomy (POEM) more effective than pneumatic dilation and Heller myotomy? A systematic review and meta-analysis.Surgical endoscopy · 2021Pooled it
- Risk factors for gastroesophageal reflux after POEM for achalasia: a systematic review and meta-analysis.Surgical endoscopy · 2021Pooled it
- Peroral endoscopic myotomyWorld journal of gastroenterology · 2022Trial
- Endoscopic management of esophagomediastinal fistula following peroral endoscopic myotomy.Surgical endoscopy · 2025Article
- Evolving therapeutic approaches in achalasia: a comprehensive review of peroral endoscopic myotomy (POEM) vs. Heller's myotomy.Annals of medicine and surgery (2012) · 2025Review
- Gastroesophageal reflux disease over time in endoscopic versus surgical myotomy for treatment of achalasia: Systematic review and meta-analysis.Endoscopy international open · 2025Review
- Impedance planimetry during per-oral endoscopic myotomy is associated with decreased inadvertent capnoperitoneum.Surgical endoscopy · 2024Article
- Using impedance planimetry to define the end of a peroral endoscopic myotomy.Surgical endoscopy · 2024Article
- Clinical and financial outcomes of per-oral endoscopic myotomy compared to laparoscopic heller myotomy for treatment of achalasia.Surgical endoscopy · 2023Article
- Review
- Peroral Endoscopy Myotomy (POEM) for Esophageal Motility Disorders.Current gastroenterology reports · 2022Review
- Changes in Distensibility Index During an Incremental POEM Myotomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- POEM, GPOEM, and ZPOEM.Digestive diseases and sciences · 2022Review
- Long-term outcomes of per-oral endoscopic myotomy compared to laparoscopic Heller myotomy for achalasia: a single-center experience.Surgical endoscopy · 2021Article
- Per-oral endoscopic myotomy and gastroesophageal reflux: Where do we stand after a decade of "POETRY"?Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2019Review
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
objectiveTo report our experience in POEM vs. LHM, with particular focus on myotomy extension.
backgroundPOEM has been adopted worldwide as a treatment for achalasia. While resolution of dysphagia is above 90%, postoperative reflux ranges from 10 to 57%. Myotomy length has been a controversial topic.
methodsThirty-five cases of POEM were prospectively analyzed and compared retrospectively to the last 35 patients that underwent LHM, from December 2010 to August 2016. Mean follow-up was 10 months (6/32) for POEM and 20 months (6/68) for LHM. All patients with LHM had a myotomy extension ≥3 cm on the gastric side. In POEM cases, extension was defined by direct vision (Hill type II) and never exceeded 2 cm.
resultsFollow-up was completed in 100% of patients. Efficacy (ES ≤ 3) was 33/35 (94.2%) for POEM and 32/35 (91.4%) for LHM in a short-term follow-up (p = 1.000) and 31/35 (88.6%) and 27/35 (77.1%), respectively, in a long-term follow-up (p = 1.000), with average ES drop from 9 to 1.2 (p = 0.0001) in POEM vs. 9.2 to 1.3 (p = 0.0001) in LHM. Major Postoperative complications occurred in 1 patient (leak) for LHM and 1 patient (massive capnothorax) in POEM. Hospital stay was shorter for POEM than for LHM (1.3 vs. 2.1, respectively) (p = 0.0001). Symptomatic reflux cases included 7/35 POEM (20%) vs. 6/35 LHM (17.1%) (p = 0.4620). Esophagitis signs in endoscopy appeared in 1/21 POEM (4.7%) vs. 1/22 LHM (4.5%) (p = 1.000). Patients requiring PPI included 8/35 POEM (22.8%) vs. 7/35 LHM (20%) (p = 0.6642). Further treatment (endoscopic dilation) was performed in 10/35 POEM (28.5%) vs. 8/35 LHM (22.8%).
conclusionsA shorter myotomy on the gastric side in POEM may contribute to an acceptable reflux rate with comparable relief of dysphagia. Although our follow-up for POEM is shorter than for LHM, the trends are promising and warrant future prospective studies to address this topic.
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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.