ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2020
Revisional Surgery in Patients with Recurrent Dysphagia after Heller Myotomy.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Redo Heller myotomy vs. POEM after failed Heller myotomy: a systematic review and meta-analysis.Surgical endoscopy · 2026Pooled it
- Robotic versus laparoscopic heller myotomy for esophageal achalasia: an updated systematic review and meta-analysis.Langenbeck's archives of surgery · 2025Pooled it
- Management of Recurrent Dysphagia after POEM and Heller Myotomy: Current Strategies and Future Directions.Current gastroenterology reports · 2026Review
- Clinical course of chest pain associated with esophageal motility disorders following peroral endoscopic myotomy.Esophagus : official journal of the Japan Esophageal Society · 2026Article
- Safety, efficacy, and patient satisfaction after esophagectomy for esophageal neuromotor disease: A single-institution experience.JTCVS open · 2025Article
- Peroral endoscopic myotomy plus natural orifice transluminal endoscopic wrap release for dysphagia after laparoscopic Heller myotomy and Dor fundoplication.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025Article
- Surgical Options for End-Stage Achalasia.Current gastroenterology reports · 2023Review
- Recurrent dysphagia after myotomy for achalasia: pneumatic dilation or POEM? : Which modality offers superior outcomes?Surgical endoscopy · 2023Article
- MANAGEMENT OF SYMPTOMS RECURRENCE AFTER MYOTOMY FOR ACHALASIA. A PRACTICAL APPROACH.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2023Review
- Revisional Therapy for Recurrent Symptoms After Heller Myotomy for Achalasia.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Discordance between high-resolution manometry, esophagoscopy and contrast esophagogram in determining landmarks for per-oral endoscopic myotomy in spastic esophageal disorders: a word of caution.Surgical endoscopy · 2021Article
- Laparoscopic Revisional Surgery After Failed Heller Myotomy for Esophageal Achalasia: Long-Term Outcome at a Single Tertiary Center.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Recurrence of dysphagia post-myotomy: etiologies and management.Revista do Colegio Brasileiro de Cirurgioes · 2021Article
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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
backgroundRecurrent/persistent symptoms of achalasia occur in 10-20% of individuals after Heller myotomy. The causes and treatment outcomes are ambiguous. Our aim is to assess the causes and outcomes of a multidisciplinary approach to this patient population.
methodsAll patients undergoing revisional operations after a Heller myotomy were reviewed retrospectively. DATA COLLECTED: demographics, date of initial Heller myotomy, preoperative evaluation, etiology of recurrent symptoms, date of revisional operation, and surgical outcomes.
resultsA total of 34 patients underwent 37 revisional operations. Operations were tailored based on preoperative multidisciplinary evaluation. Causes of symptoms: periesophageal/perihiatal fibrosis 11 (27%), obstructing fundoplication 11 (27%), incomplete myotomy 8 (20%), progression of disease 9 (22%), and epiphrenic diverticulum 1 (2%). Operations performed: reversal/no creation of fundoplication with or without re-do myotomy 22 (59%), revision/creation of fundoplication with or without myotomy 6 (16%), and esophagectomy 9 (24%). Ten patients in the 37 operations (27%) developed postoperative complications. Of 33 patients for 36 operations with follow-up, 25 patient-operations (69%) resulted in resolution or improved dysphagia. Although there was variation in symptomatic improvement by cause and operation type, none reached statistical significance.
conclusionThere are several causes of dysphagia after Heller myotomy and a thoughtful evaluation is required. Complication rates are higher than first-time operations. Symptomatic improvement occurs in the majority of cases, but a significant minority will have persistent dysphagia. Although an individualized approach to dysphagia after Heller myotomy may improve symptoms and passage of food, the perception of dysphagia may persist in patients.
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