ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022
Revisional Therapy for Recurrent Symptoms After Heller Myotomy for Achalasia.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Robotic versus laparoscopic heller myotomy for esophageal achalasia: an updated systematic review and meta-analysis.Langenbeck's archives of surgery · 2025Pooled it
- Developing consensus in post-myotomy dysphagia: a Delphi study integrating anatomic and physiologic assessment from the ACTION group.Surgical endoscopy · 2026Article
- Management of Recurrent Dysphagia after POEM and Heller Myotomy: Current Strategies and Future Directions.Current gastroenterology reports · 2026Review
- Recurrent symptoms after achalasia treatment: The value of impedance analysis.United European gastroenterology journal · 2025Article
- Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand.Clinical endoscopy · 2024Article
- Robotic Heller's cardiomyotomy for achalasia: early outcomes for a high-volume UK centre.Annals of the Royal College of Surgeons of England · 2024Article
- MANAGEMENT OF SYMPTOMS RECURRENCE AFTER MYOTOMY FOR ACHALASIA. A PRACTICAL APPROACH.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2023Review
- From laparoscopic to robotic-assisted Heller myotomy for achalasia in a single high-volume visceral surgery center: postoperative outcomes and quality of life.BMC surgery · 2022Article
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Authors and funding
6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeSymptom recurrence after initial surgical management of esophageal achalasia occurs in 10-25% of patients. The aim of this study was to analyze safety and efficacy of revisional therapy after failed Heller myotomy (HM).
methodsA retrospective review of a prospective database was performed searching for patients with recurrent symptoms after primary surgical therapy for achalasia. Patients with previously failed HM were considered for the final analysis. The Foregut questionnaire, and the Atkinson and Eckardt scales were used to assess severity of symptoms. Objective investigations routinely included upper gastrointestinal endoscopy and barium swallow study. Redo treatments consisted of endoscopic pneumatic dilation (PD), laparoscopic HM, hybrid Ivor Lewis esophagectomy, or stapled cardioplasty. A yearly clinical and endoscopic follow-up was scheduled in all patients.
resultsOver a 20-year period, 26 patients with a median age of 66 years (IQR 19.5) underwent revisional therapy after failed HM for achalasia at a tertiary-care university hospital. The median time after index procedure was 10 years (IQR 21). Revisional therapy consisted of endoscopic pneumatic dilation (n=13), laparoscopic HM and fundoplication (n=10), esophagectomy (n=2), and stapled cardioplasty and fundoplication (n=1). Nine (34.6%) of these patients required further endoscopic or surgical treatments. There was no mortality, and the overall complication rate was 7.7%. At a median follow-up of 42 months (range 10-149), a significant decrease of dysphagia, regurgitation, chest pain, respiratory symptoms, and median Eckardt score (p<0.05) was noted.
conclusionIn specialized and multidisciplinary centers, revisional therapy for achalasia is feasible, safe, and effective.
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