Evidence map›Paper›PMID 32157405›Full record

ArticleSurgical endoscopy2021

Long-term outcomes of per-oral endoscopic myotomy compared to laparoscopic Heller myotomy for achalasia: a single-center experience.

Alexander J Podboy, Joo Ha Hwang, Homero Rivas, Dan Azagury, Mary Hawn, James Lau, Afrin Kamal, Shai Friedland, George Triadafilopoulos, Thomas Zikos and 1 more

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 6 pooled it
–field-weighted citation impact
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

30 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  5. 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 · 2024
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  9. Saudi Gastroenterology Association (SGA) clinical care pathway and standards of care for peroral endoscopic myotomy (POEM) in achalasia.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026
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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

11 authors.

Alexander J PodboyDivision of Gastroenterology & Hepatology, Stanford University Hospital, GI Suite, 430 Broadway, Pavilion C-3rd Floor, Redwood City, CA, 94063, USA.
Joo Ha HwangDivision of Gastroenterology & Hepatology, Stanford University Hospital, GI Suite, 430 Broadway, Pavilion C-3rd Floor, Redwood City, CA, 94063, USA.
Homero RivasDivision of General Surgery, Stanford University Hospital, Stanford, CA, USA.
Dan AzaguryDivision of General Surgery, Stanford University Hospital, Stanford, CA, USA.
Mary HawnDivision of General Surgery, Stanford University Hospital, Stanford, CA, USA.
James LauDivision of General Surgery, Stanford University Hospital, Stanford, CA, USA.
Afrin KamalDivision of Gastroenterology & Hepatology, Stanford University Hospital, GI Suite, 430 Broadway, Pavilion C-3rd Floor, Redwood City, CA, 94063, USA.
Shai FriedlandDivision of Gastroenterology & Hepatology, Stanford University Hospital, GI Suite, 430 Broadway, Pavilion C-3rd Floor, Redwood City, CA, 94063, USA.
George TriadafilopoulosDivision of Gastroenterology & Hepatology, Stanford University Hospital, GI Suite, 430 Broadway, Pavilion C-3rd Floor, Redwood City, CA, 94063, USA.
Thomas ZikosDivision of Gastroenterology & Hepatology, Stanford University Hospital, GI Suite, 430 Broadway, Pavilion C-3rd Floor, Redwood City, CA, 94063, USA.
John O ClarkeDivision of Gastroenterology & Hepatology, Stanford University Hospital, GI Suite, 430 Broadway, Pavilion C-3rd Floor, Redwood City, CA, 94063, USA. jclarke2@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMany centers have reported excellent short-term efficacy of per-oral endoscopic myotomy (POEM) for the treatment of achalasia. However, long-term data are limited and there are few studies comparing the efficacy of POEM versus Heller Myotomy (HM).

aimsTo compare the long-term clinical efficacy of POEM versus HM.

methodsUsing a retrospective, parallel cohort design, all cases of POEM or HM for achalasia between 2010 and 2015 were assessed. Clinical failure was defined as (a) Eckardt Score > 3 for at least 4 weeks, (b) achalasia-related hospitalization, or (c) repeat intervention. All index manometries were classified via Chicago Classification v3. Pre-procedural clinical, manometric, radiographic data, and procedural data were reviewed.

results98 patients were identified (55 POEM, 43 Heller) with mean follow-up of 3.94 years, and 5.44 years, respectively. 83.7% of HM patients underwent associated anti-reflux wrap (Toupet or Dor). Baseline clinical, demographic, radiographic, and manometric data were similar between the groups. There was no statistical difference in overall long-term success (POEM 72.7%, HM 65.1% p = 0.417, although higher rates of success were seen in Type III Achalasia in POEM vs Heller (53.3% vs 44.4%, p < 0.05). Type III Achalasia was the only variable associated with failure on a univariate COX analysis and no covariants were identified on a multivariate Cox regression. There was no statistical difference in GERD symptoms, esophagitis, or major procedural complications.

conclusionPOEM and HM have similar long-term (4-year) efficacy with similar adverse event and reflux rates. POEM was associated with greater efficacy in Type III Achalasia.

Indexed as

Cohort StudiesEndoscopyEsophageal AchalasiaFemaleHeller MyotomyHumansLaparoscopyMaleMiddle AgedRetrospective StudiesTreatment OutcomeAchalasiaEsophagusGERDPOEM

Identifiers

PMID32157405

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.