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New research · Gastroenterology
Digestive diseases and sciences · 22h
Cohort studyDigestive diseases and sciences · 2026

Results of Laparoscopic Heller Myotomy in Achalasia Patients with Persistent or Recurrent Symptoms After Peroral Endoscopic Myotomy (POEM).

Elise M Wessels, Gwen M C Masclee, Marlies P Schijven, Albert J Bredenoord
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GastroenterologyCohort study

Laparoscopic Heller myotomy after failed peroral endoscopic myotomy has low long-term success.

Results of Laparoscopic Heller Myotomy in Achalasia Patients with Persistent or Recurrent Symptoms After Peroral Endoscopic Myotomy (POEM).

Elise M Wessels et al. · Digestive diseases and sciences · 2026
Background

Peroral endoscopic myotomy (POEM) is an effective and safe treatment for achalasia.

Purpose

The aim of this study was to examine the efficacy and safety of performing laparoscopic Heller myotomy (LHM) in achalasia patients having persistent or recurrent symptoms after POEM.

Methods

This retrospective study includes patients who underwent LHM after they failed on POEM, which was performed between August 2011 and March 2024.

n = 22 patients
13.6%
Results
this low percentage of patients had successful symptom control from the follow-up surgery
n = 22 patients
More results

A marked decline in success rate of LHM following POEM was observed over time: approximately 70% after one year and 30% after two years.

For patients with treatment failure after LHM, 73.7% required retreatment (n = 14/19), predominantly with pneumatic dilation.

“
Conclusion

LHM following POEM yields only minimal benefit with a rapid loss of success over time. These outcomes suggest limited clinical value of LHM following POEM failure and indicate that alternative strategies may be preferable.

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