Trial reportSurgical endoscopy2018
Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: long-term symptomatic follow-up of a prospective randomized controlled trial.
Trial report in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
22 citing papers in PubMed, 5 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Fundoplication in laparoscopic Heller's cardiomyotomy for achalasia.The Cochrane database of systematic reviews · 2022Pooled it
- Heller myotomy versus Heller myotomy with fundoplication in patients with achalasia: a systematic review and meta-analysis.Annals of the Royal College of Surgeons of England · 2022Pooled 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
- Updated Systematic Review of Achalasia, with a Focus on POEM Therapy.Digestive diseases and sciences · 2020Pooled it
- Intraoperative indocyanine green (ICG) fluorescence to assess mucosal integrity during laparoscopic Heller-Dor surgery: a pilot randomized study.Updates in surgery · 2026Article
- Laparoscopic Heller myotomy with Dor fundoplication for achalasia: an outcome in a tertiary health center of Nepal.Frontiers in surgery · 2026Article
- Surgical and endoscopic interventions in the management of idiopathic achalasia.The Cochrane database of systematic reviews · 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
- Imaging following endoscopic and surgical treatment of achalasia.Abdominal radiology (New York) · 2025Review
- Comparison of laparoscopic Heller myotomy and endoscopic balloon dilation in the treatment of achalasia: Effects on quality of life and patient satisfaction.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2024Article
- Laparoscopic Esocardiomyotomy-Risk Factors and Implications of Intraoperative Mucosal Perforation.Life (Basel, Switzerland) · 2023Article
- Robotic Heller myotomy and Dor fundoplication: Twelve steps.JTCVS techniques · 2022Article
- POEM, GPOEM, and ZPOEM.Digestive diseases and sciences · 2022Review
- 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
- Preoperative physiological esophageal assessment for anti-reflux surgery: A guide for surgeons on high-resolution manometry and pH testing.World journal of gastroenterology · 2021Review
- Endoscopic and Surgical Treatments for Achalasia: Who to Treat and How?Gastroenterology clinics of North America · 2020Review
- Outcomes of Laparoscopic Heller Myotomy for Achalasia: 22-Year Experience.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
- Surgical Management of Gastroesophageal Reflux Disease in Patients with Severe Esophageal Dysmotility.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundOur prior randomized controlled trial of Heller myotomy alone versus Heller plus Dor fundoplication for achalasia from 2000 to 2004 demonstrated comparable postoperative resolution of dysphagia but less gastroesophageal reflux after Heller plus Dor. Patient-reported outcomes are needed to determine whether the findings are sustained long-term.
methodsWe actively engaged participants from the prior randomized cohort, making up to six contact attempts per person using telephone, mail, and electronic messaging. We collected patient-reported measures of dysphagia and gastroesophageal reflux using the Dysphagia Score and the Gastroesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) instrument. Patient-reported re-interventions for dysphagia were verified by obtaining longitudinal medical records.
resultsAmong living participants, 27/41 (66%) were contacted and all completed the follow-up study at a mean of 11.8 years postoperatively. Median Dysphagia Scores and GERD-HRQL scores were slightly worse for Heller than Heller plus Dor but were not statistically different (6 vs 3, p = 0.08 for dysphagia, 15 vs 13, p = 0.25 for reflux). Five patients in the Heller group and 6 in Heller plus Dor underwent re-intervention for dysphagia with most occurring more than five years postoperatively. One patient in each group underwent redo Heller myotomy and subsequent esophagectomy. Nearly all patients (96%) would undergo operation again.
conclusionsLong-term patient-reported outcomes after Heller alone and Heller plus Dor for achalasia are comparable, providing support for either procedure.
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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.