ArticleSurgical endoscopy2023
Laparoscopic Heller-Dor is an effective long-term treatment for end-stage achalasia.
Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Comprehensive evaluation of current strategies in achalasia treatment: Insights from an umbrella review.Medicine · 2025Pooled it
- Long-term outcome of peroral endoscopic myotomy for sigmoid-type achalasia: S1 vs S2 subtypes.Surgical endoscopy · 2026Article
- Simultaneous surgical treatment of morbid obesity and end-stage achalasia: a case report and review of literature.Frontiers in surgery · 2026Article
- Esophageal tortuosity in achalasia: increased length-to-height ratio predicts inferior symptom relief and esophageal emptying following myotomy.Surgical endoscopy · 2025Article
- Gastroesophageal reflux disease over time in endoscopic versus surgical myotomy for treatment of achalasia: Systematic review and meta-analysis.Endoscopy international open · 2025Review
- Long-term outcomes of treatment for achalasia: Laparoscopic Heller myotomy versus POEM.Annals of gastroenterological surgery · 2024Review
- Quantifying the subjective: length-to-height ratio characterizes achalasia esophageal tortuosity.Surgical endoscopy · 2023Article
- Precision Endoscopy in Peroral Myotomies for Motility Disorders of the Upper Gastrointestinal Tract: Current Insights and Prospective Avenues-A Comprehensive Review.Life (Basel, Switzerland) · 2023Review
- A case report of end-stage achalasia: Conservative option as the new surgical standard.International journal of surgery case reports · 2023Article
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe end-stage achalasia is a difficult condition to treat, for the esophageal diameter and conformation of the gullet, that may progress to a sigmoid shape. The aim of this study was to examine the outcome of Laparoscopic Heller-Dor in patients with end-stage achalasia, comparing them with patients who had mega-esophagus without a sigmoid shape.
methodsFrom 1992 to 2020, patients with a diagnosis of sigmoid esophagus, or radiological stage IV achalasia (the SE group), and patients with a straight esophagus larger than 6 cm in diameter, or radiological stage III achalasia (the NSE group), were all treated with LHD. The two groups were compared in terms of patients' symptoms, based on the Eckardt score, and on barium swallow, endoscopy and manometry performed before and after the treatment. The failure of the treatment was defined as an Eckardt score > 3, or the need for further treatment.
resultsThe study involved 164 patients: 73 in the SE group and 91 in the NSE group. No intra- or postoperative mortality was recorded. The median follow-up was 51 months (IQR 25-107). The outcome was satisfactory in 71.2% of patients in the SE group, and in 89% of those in the NSE group (p = 0.005).
conclusionsSE is certainly the worst condition of the disease and the final outcome of LHD, in term of symptom control, is inferior compared to NSE. Despite this, almost 3/4 of the SE patients experienced a significant relieve in symptoms after LHD, which may therefore still be the first surgical option to offer to these patients, before considering esophagectomy.
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