ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019
A Thousand and One Laparoscopic Heller Myotomies for Esophageal Achalasia: a 25-Year Experience at a Single Tertiary Center.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 5 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 5 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- Redo Heller myotomy vs. POEM after failed Heller myotomy: a systematic review and meta-analysis.Surgical endoscopy · 2026Pooled it
- Long-term outcomes of peroral endoscopic myotomy for achalasia: a systematic review and meta-analysis with median follow-up ≥ 5 years.Surgical endoscopy · 2026Pooled it
- ADVANCED MEGAESOPHAGUS TREATMENT: WHICH TECHNIQUE OFFERS THE BEST RESULTS? A SYSTEMATIC REVIEW.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024Pooled it
- European guidelines on achalasia: United European Gastroenterology and European Society of Neurogastroenterology and Motility recommendations.United European gastroenterology journal · 2020Guideline
- Updated Systematic Review of Achalasia, with a Focus on POEM Therapy.Digestive diseases and sciences · 2020Pooled it
- Laparoscopic Heller-Dor as salvage therapy after failed POEM: a prospective comparative study.Surgical endoscopy · 2026Article
- Five-year follow-up results of the Italian case-control study comparing poem and laparoscopic Heller myotomy using the propensity score.Surgical endoscopy · 2026Article
- Comparison of Achalasia Classification Schemes to Predict Treatment Outcomes.Neurogastroenterology and motility · 2026Article
- Simultaneous surgical treatment of morbid obesity and end-stage achalasia: a case report and review of literature.Frontiers in surgery · 2026Article
- Functional-Structural Correlates in Achalasia: The Relationship of Esophageal Pressurization and Anatomy.Neurogastroenterology and motility · 2025Article
- Limited hiatal dissection versus Dor-fundoplication in laparoscopic Heller myotomy for achalasia: First experience in Morocco - A case control comparison study.International journal of surgery case reports · 2025Article
- Padua Days on Muscle and Mobility Medicine, March 25-29, 2025, Hotel Petrarca, Euganean Thermae, Italy: Program and Abstracts.European journal of translational myology · 2025Article
- Presence of eosinophils may represent an earlier stage in achalasia pathogenesis.Therapeutic advances in gastroenterology · 2025Article
- Serra doria procedure as an alternative treatment for end stage achalasia. A case report.Heliyon · 2024Article
- Long-term outcomes of treatment for achalasia: Laparoscopic Heller myotomy versus POEM.Annals of gastroenterological surgery · 2024Review
- Role of modified Glasgow Prognostic Score in patients with achalasia who underwent laparoscopic Heller-myotomy with Dor-fundoplication.Esophagus : official journal of the Japan Esophageal Society · 2024Article
- Influence of Achalasia on the Spirometry Flow-Volume Curve and Peak Expiratory Flow.Diagnostics (Basel, Switzerland) · 2024Article
- Long-term outcomes of laparoscopic Heller's myotomy with angle of His accentuation in patients of achalasia cardia.Surgical endoscopy · 2024Article
- Characteristics of achalasia and detection of pulmonary complications: A comparison of findings in younger and elderly patients.Qatar medical journal · 2024Article
- Single-center experience of transitioning from video-assisted laparoscopic to robotic Heller myotomy with Dor fundoplication for esophageal motility disorders.BMC surgery · 2023Observational
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to assess the long-term outcome of laparoscopic Heller-Dor (LHD) myotomy to treat achalasia at a single high-volume institution in the past 25 years.
methodsPatients undergoing LHD from 1992 to 2017 were prospectively registered in a dedicated database. Those who had already undergone surgical or endoscopic myotomy were ruled out. Symptoms were collected and scored using a detailed questionnaire; barium swallow, endoscopy, and manometry were performed before and after surgery; and 24-h pH monitoring was done 6 months after LHD.
resultsOne thousand one patients underwent LHD (M:F = 536:465), performed by six staff surgeons. The surgical procedure was completed laparoscopically in all but 8 patients (0.8%). At a median of follow-up of 62 months, the outcome was positive in 896 patients (89.5%), and the probability of being cured from symptoms at 20 years exceeded 80%. Among the patients who had previously received other treatments, there were 25/182 failures (13.7%), while the failures in the primary treatment group were 80/819 (9.8%) (p = 0.19). All 105 patients whose LHD failed subsequently underwent endoscopic pneumatic dilations with an overall success rate of 98.4%. At univariate analysis, the manometric pattern (p < 0.001), the presence of a sigmoid megaesophagus (p = 0.03), and chest pain (p < 0.001) were the factors that predicted a poor outcome. At multivariate analysis, all three factors were independently associated with a poor outcome. Post-operative 24-h pH monitoring was abnormal in 55/615 patients (9.1%).
conclusionsLHD can durably relieve achalasia symptoms in more than 80% of patients. The pre-operative manometric pattern, the presence of a sigmoid esophagus, and chest pain represent the strongest predictors of outcome.
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