Evidence map›Paper›PMID 41366919›Full record

SynthesisMedicine2025

Comprehensive evaluation of current strategies in achalasia treatment: Insights from an umbrella review.

Negin Letafatkar, Arman Habibi, Fatemeh Mohammadyari, Farahnaz Joukar, Sara Nobakht, Seyed-Kazem Hosseini-Ghaziani, Mohammad-Hossein Keivanlou, Ehsan Amini-Salehi, Soheil Hassanipour, Fariborz Mansour-Ghanaei

Abstract readSystematic Review
In one paragraph

Synthesis in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Negin LetafatkarGastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Arman Habibi
Fatemeh Mohammadyari
Farahnaz Joukar
Sara Nobakht
Seyed-Kazem Hosseini-Ghaziani
Mohammad-Hossein Keivanlou
Ehsan Amini-Salehi
Soheil HassanipourORCID 0000-0002-6661-4908
Fariborz Mansour-Ghanaei

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAchalasia poses a considerable clinical challenge due to its complex pathophysiology and varied treatment responses. This umbrella review aims to consolidate current meta-analyses, providing a comprehensive evaluation of treatment efficacy across various methodologies. By employing statistical analyses and concise quality assessment, we seek to standardize outcomes and effectively highlight the limitations inherent in existing research.

methodsA comprehensive literature search was conducted across 5 international databases, including PubMed, Scopus, Web of Science, Embase, and the Cochrane Library, to identify relevant meta-analyses focused on achalasia treatments. Key parameters evaluated included clinical success rates, complications, operation times, and lengths of hospital stay. Statistical synthesis was employed to compare treatment effectiveness across studies.

resultsThe initial search identified 1037 records, of which 23 meta-analysis studies were included in this study. This review suggests that peroral endoscopic myotomy (POEM) may be comparable to, or potentially more effective than, Heller myotomy in the short-term management of achalasia. However, this was not further supported in longer follow-up durations. While POEM offers advantages such as shorter hospital stays, the ability to perform longer myotomies, and reduced operative duration, it demonstrated a greater risk of gastroesophageal reflux. However, the existing data are insufficiently conclusive, underscoring the need for additional long-term, high-quality studies to validate these results.

conclusionThis review highlights the comparable efficacy and safety of POEM and Heller myotomy in the treatment of achalasia. The variability in study quality and the presence of methodological flaws in the conducted studies underlines the need for further long-term research, improved methodological rigor, and standardized treatment protocols to optimize patient management in achalasia.

Indexed as

Esophageal AchalasiaHeller MyotomyHumansLength of StayMeta-Analysis as TopicOperative TimeTreatment Outcomeachalasiabotulinum toxinlaparoscopic Heller myotomyoverview reviewperoral endoscopic myotomy (POEM)pneumatic dilatationumbrella review

Identifiers

PMID41366919
PMCPMC12689109

What OpenQuestion holds

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Registered trials

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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.