Evidence map›Paper›PMID 31691117›Full record

SynthesisUpdates in surgery2019

Esophageal achalasia after Roux-en-Y gastric bypass for morbid obesity.

María A Casas, Francisco Schlottmann, Fernando A M Herbella, Rudolf Buxhoeveden, Marco G Patti

Abstract readCase ReportsSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Updates in surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 3 countries.

María A CasasDepartment of Surgery, Hospital Alemán of Buenos Aires, University of Buenos Aires, Av. Pueyrredón 1640, ATT 1118, Buenos Aires, Argentina.
Francisco SchlottmannDepartment of Surgery, Hospital Alemán of Buenos Aires, University of Buenos Aires, Av. Pueyrredón 1640, ATT 1118, Buenos Aires, Argentina. fschlottmann@hotmail.com.ORCID http://orcid.org/0000-0003-3565-0559
Fernando A M HerbellaDepartment of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil.
Rudolf BuxhoevedenDepartment of Surgery, Hospital Alemán of Buenos Aires, University of Buenos Aires, Av. Pueyrredón 1640, ATT 1118, Buenos Aires, Argentina.
Marco G PattiDepartment of Medicine and Surgery, University of North Carolina, Chapel Hill, NC, USA.
Universidad de Buenos Aires · ARUniversidade Federal de São Paulo · BRUniversity of North Carolina at Chapel Hill · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The development of achalasia in patients with a prior Roux-en-Y gastric bypass (RYGB) is rare and it often remains unclear whether the esophageal motility disorder is a pre-existing condition in the obese patient or develops de novo after the procedure. The aim of this study was to review the available evidence regarding the management of patients with achalasia after a RYGB. Intra-sphincteric injection of botulinum toxin and pneumatic dilatation can be used to eliminate the functional obstruction at the level of the gastroesophageal junction. However, considering that achalasia patients after RYGB are often young and these treatment modalities have shown worse long-term outcomes, endoscopic or surgical myotomy is preferred. Per-oral endoscopic myotomy (POEM) is a very effective first line of treatment, and as RYGB is an excellent anti-reflux operation per se, post-POEM reflux may not be an issue in these patients. Laparoscopic Heller myotomy (LHM) is also an effective and safe therapy in achalasia patients with RYGB anatomy, and the gastric remnant can be safely used to perform a fundoplication to cover the myotomy. LHM and POEM are both acceptable primary treatment modalities in this setting. Further studies are needed to elucidate the pathophysiology and optimal management of patients with achalasia after RYGB.

Indexed as

AdultBotulinum ToxinsDilatationEsophageal AchalasiaFemaleFundoplicationGastric BypassHeller MyotomyHumansObesity, MorbidPostoperative ComplicationsPyloromyotomyBotulinum ToxinsAchalasiaGastric bypassHeller myotomyObesityPOEM

Identifiers

PMID31691117
OpenAlexW2984010586

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.