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lüll Recurrent achalasia treated with Heller myotomy: a review of the literature Wang L; Li YMWorld J Gastroenterol 2008[Dec]; 14 (46): 7122-6AIM: To evaluate the efficacy and safety of Heller myotomy (HM) for recurrent achlasia, performed after different methods of first-line treatment. METHODS: We searched for studies published in PubMed from 1966 to March 2008 on treatment of recurrent achalasia with HM after failure with different methods of first-line treatment. The efficacy of HM was assessed by a pooled estimate of response rate with individual studies weighted proportionally to sample size. RESULTS: Sixteen studies were eligible and included in the review. The results showed that HM has a better remission rate for recurrent achalasia after failure of HM [weighted mean (SD)] of 86.9% (21.8%) compared with 81.6% (23.8%) for pneumatic dilatation (PD). One study evaluated the efficacy of HM after failure of PD combined with botulinum toxin injection (83%). The most common complications were perforation and gastroesophageal reflux. CONCLUSION: HM has the best efficacy in patients with recurrent achlasia who were treated with HM as first-line treatment. Future studies should focus on how to increase the success rate and decrease the complications of HM.|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Child[MESH]|Digestive System Surgical Procedures/adverse effects/*methods[MESH]|Esophageal Achalasia/*surgery[MESH]|Esophagus/surgery[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Secondary Prevention[MESH]|Treatment Outcome[MESH]|Young Adult[MESH] |