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Review
. 2023 May;33(2):135-140.
doi: 10.1016/j.thorsurg.2023.01.007. Epub 2023 Feb 26.

Achalasia: Surgery Versus Per-Oral Endoscopic Myotomy

Sadia Tasnim  1 , Siva Raja  2 , Monisha Sudarshan  3
Affiliations
Review

Achalasia: Surgery Versus Per-Oral Endoscopic Myotomy

Sadia Tasnim et al. Thorac Surg Clin. 2023 May.

Abstract

Approaches to achalasia include non-operative and operative techniques with Heller Myotomy and Per-Oral Endoscopic Myotomy (POEM) at the forefront of palliative strategies. Given the diverse subtypes and the time-dependent failure pattern for achalasia, there is no standard approach. We elect for a POEM for type III achalasia, poor functional status, hostile abdomen, and salvage after the previous myotomy. A Heller myotomy is elected over a POEM for type II achalasia, presence of diverticulum, and hiatal hernia. As long-term outcomes become available, an optimal customized strategy will become clearer.

Keywords: Achalasia; Dor fundoplication; Heller myotomy; POEM.

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