Evidence map›Paper›PMID 38564157›Full record

SynthesisIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2024

Efficacy and safety of laparoscopic Heller's myotomy versus pneumatic dilatation for achalasia: A systematic review and meta-analysis of randomized controlled trials.

Adnan Malik, Shahbaz Qureshi, Abdul Nadir, Muhammad Imran Malik, Douglas G Adler

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 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

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Achalasia management with per-oral endoscopic myotomy: A study of clinical success and complications at a tertiary center in Saudi Arabia.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026
    Article
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.

Adnan MalikDivision of Gastroenterology, Mountain Vista Medical Center, Mesa, AZ, USA.
Shahbaz QureshiDivision of Gastroenterology, Mountain Vista Medical Center, Mesa, AZ, USA.
Abdul NadirDivision of Gastroenterology, Mountain Vista Medical Center, Mesa, AZ, USA.
Muhammad Imran MalikAiredale General Hospital, West Yorkshire, UK.
Douglas G AdlerCenter for Advanced Therapeutic Endoscopy Centura Health, Porter Adventist Hospital, Denver, CO, USA. dougraham2001@gmail.com.ORCID 0000-0003-3214-6285

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND 

objectivesAchalasia has several treatment modalities. We aim to compare the efficacy and safety of laparoscopic Heller myotomy (LHM) with those of pneumatic dilatation (PD) in adult patients suffering from achalasia.

methodsWe searched Cochrane CENTRAL, PubMed, Web of Science, SCOPUS and Embase for related clinical trials about patients suffering from achalasia. The quality appraisal and assessment of risk of bias were conducted with GRADE and Cochrane's risk of bias tool, respectively. Homogeneous and heterogeneous data was analyzed under fixed and random-effects models, respectively.

resultsThe pooled analysis of 10 studies showed that PD was associated with a higher rate of remission at three months, one year, three years and five years (RR = 1.25 [1.09, 1.42] (p = 0.001); RR = 1.13 [1.05, 1.20] (p = 0.0004); RR = 1.48 [1.19, 1.82] (p = 0.0003); RR = 1.49 [1.18, 1.89] (p = 0.001)), respectively. LHM was associated with lower number of cases suffering from adverse events, dysphagia and relapses (RR = 0.50 [0.25, 0.98] (p = 0.04); RR = 0.33 [0.16, 0.71] (p = 0.004); RR = 0.38 [0.15, 0.97] (p = 0.04)), respectively. There is no significant difference between both groups regarding the lower esophageal pressure, perforations, remission rate at two years, Eckardt score after one year and reflux.

conclusionPD had higher remission rates than LHM at three months, one year and three years, but not at two years or five years. More research is needed to determine whether PD has a significant advantage over LHM in terms of long-term remission rates.

Indexed as

DilatationEsophageal AchalasiaHeller MyotomyLaparoscopyAdultFemaleHumansMaleMiddle AgedRandomized Controlled Trials as TopicSafetyTreatment OutcomeAchalasiaAchalasia cardiaDifficulty of swallowingDysphagiaEsophageal achalasiaEsophageal dysphagiaEsophageal endoscopyEsophageal manometryEsophageal motility disordersGastroesophageal reflux diseaseLaparoscopic Heller myotomyPneumatic dilatation

Identifiers

PMID38564157

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.