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Review
. 2020 Dec;1481(1):236-246.
doi: 10.1111/nyas.14440. Epub 2020 Jul 26.

Achalasia: what to do in the face of failures of Heller myotomy

Valter N Felix  1 , Kenric M Murayama  2 , Luigi Bonavina  3 , Moo In Park  4
Affiliations
Free article
Review

Achalasia: what to do in the face of failures of Heller myotomy

Valter N Felix et al. Ann N Y Acad Sci. 2020 Dec.
Free article

Abstract

Achalasia is a primary motility disorder of the esophagus, and while there are several treatment options, there is no consensus regarding them. When therapeutic intervention for achalasia fails, a careful evaluation of the cause of the persistent or recurrent symptoms using upper endoscopy, esophageal manometry, and contrast radiologic studies is required to understand the cause of therapy failure and guide plans for subsequent treatment. Options for reintervention are the same as for primary intervention and include pneumatic dilation, botulinum toxin injection, peroral endoscopic myotomy, or redo esophageal myotomy. When reintervention fails or if the esophagus is not amenable to intervention and the disease is considered end-stage, esophagectomy is the last option to manage recurrent achalasia.

Keywords: POEM; achalasia; esophagectomy; pneumatic dilation; redo esophageal myotomy; therapeutic methods for achalasia.

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References

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