Reintervention After Heller Myotomy for Achalasia: Is It Inevitable?

Raja and colleagues evaluated the return of symptoms and rate of reintervention following Heller myotomy for achalasia. Over a seven-year period, 248 patients underwent Heller myotomy. The majority of patients, 69%, experienced the return of at least one symptom during the follow-up period (median follow-up of 36 months), and 50 patients underwent 85 reinterventions. The majority of reinterventions were done endoscopically, and five-year freedom from reintervention was lowest for patients with type I achalasia. The authors conclude that it is important for patients to understand that Heller myotomy will likely only palliate achalasia symptoms, and they recommend lifelong postprocedural surveillance.