What does this research mean for the field?

Both Heller-Dor myotomy and per-oral endoscopic myotomy effectively relieve symptoms of esophageal achalasia, but POEM results in a significantly higher incidence of medically manageable postoperative reflux esophagitis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the surgical techniques and clinical outcomes of Heller myotomy with Dor fundoplication versus per-oral endoscopic myotomy in patients with esophageal achalasia.

August 24, 2026Diseases of the Esophagus

P1.013. Outcomes of Heller-Dor Myotomy and Per-Oral Endoscopic Myotomy for Esophageal Achalasia

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Authors

KKKengo KuriyamaGunma University MSMakoto SakaiGunma University KUKosei UeharaGunma University

Discussion

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Overview

Retrospective review reveals comparable symptom relief between Heller-Dor and per-oral endoscopic myotomy for achalasia, indicating higher reflux rates after endoscopy.

Key Points

To evaluate the surgical techniques and clinical outcomes of Heller myotomy with Dor fundoplication versus per-oral endoscopic myotomy in patients with esophageal achalasia.
Retrospective review of 68 patients with esophageal achalasia treated at a single institution (54 undergoing Heller-Dor [HD] and 14 undergoing per-oral endoscopic myotomy [POEM]).
HD involved a 6-cm esophageal and 2-cm gastric myotomy with Dor fundoplication (mostly laparoscopic, n=51), while POEM utilized circular muscle myotomy through a submucosal tunnel.
Outcomes measured included Eckardt score, lower esophageal sphincter pressure (LESP), and postoperative reflux esophagitis via Los Angeles classification.
Eckardt scores improved significantly in both the HD group (from 5.6 to 1.4, p < 0.001) and the POEM group (from 5.9 to 1.4, p < 0.001).
Lower esophageal sphincter pressure decreased significantly in both cohorts: HD (from 22.6 to 16.3 mmHg, p = 0.017) and POEM (from 31.2 to 12.3 mmHg, p = 0.002).
Postoperative reflux esophagitis (Grade A or higher) occurred more frequently after POEM (37.5%) compared to HD (9.3%, p = 0.029), though all cases were medically managed.

Cite This Study

Kuriyama et al. (2026) studied this question.

synapsesocial.com/papers/6a8c00d0bca056c88e6dfd79 https://doi.org/10.1093/dote/doag077.161

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August 24, 2026Diseases of the Esophagus

P1.013. Outcomes of Heller-Dor Myotomy and Per-Oral Endoscopic Myotomy for Esophageal Achalasia

View Full Paper

Ask AI

Bookmark

Authors

KKKengo KuriyamaGunma University MSMakoto SakaiGunma University KUKosei UeharaGunma University

Discussion

Member takes

Overview

Retrospective review reveals comparable symptom relief between Heller-Dor and per-oral endoscopic myotomy for achalasia, indicating higher reflux rates after endoscopy.

Key Points

To evaluate the surgical techniques and clinical outcomes of Heller myotomy with Dor fundoplication versus per-oral endoscopic myotomy in patients with esophageal achalasia.
Retrospective review of 68 patients with esophageal achalasia treated at a single institution (54 undergoing Heller-Dor [HD] and 14 undergoing per-oral endoscopic myotomy [POEM]).
HD involved a 6-cm esophageal and 2-cm gastric myotomy with Dor fundoplication (mostly laparoscopic, n=51), while POEM utilized circular muscle myotomy through a submucosal tunnel.
Outcomes measured included Eckardt score, lower esophageal sphincter pressure (LESP), and postoperative reflux esophagitis via Los Angeles classification.
Eckardt scores improved significantly in both the HD group (from 5.6 to 1.4, p < 0.001) and the POEM group (from 5.9 to 1.4, p < 0.001).
Lower esophageal sphincter pressure decreased significantly in both cohorts: HD (from 22.6 to 16.3 mmHg, p = 0.017) and POEM (from 31.2 to 12.3 mmHg, p = 0.002).
Postoperative reflux esophagitis (Grade A or higher) occurred more frequently after POEM (37.5%) compared to HD (9.3%, p = 0.029), though all cases were medically managed.

Cite This Study

Kuriyama et al. (2026) studied this question.

synapsesocial.com/papers/6a8c00d0bca056c88e6dfd79 https://doi.org/10.1093/dote/doag077.161

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