{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:11:41Z","timestamp":1786119101133,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Achalasia is a rare esophageal motility disorder causing dysphagia and weight loss. Severe cases may present with a significantly dilated and sigmoid-shaped esophagus (sigmoid achalasia). Traditionally, esophagectomy was used for such cases. However, laparoscopic Heller myotomy (LHM) is emerging as a less invasive alternative with comparable outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>We present a 45-year-old male with a seven-year history of dysphagia, regurgitation, chest pain, and recent weight loss. Barium esophagogram, high-resolution esophageal manometry, and upper endoscopy confirmed severe achalasia with a sigmoid esophagus (Type I according to Chicago classification). Esophagectomy was considered, but due to the patient's age and the lack of prior treatment attempts, LHM with Dor's fundoplication was performed successfully. At 24-month follow-up, the patient reported significant symptom improvement and weight gain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>While esophagectomy was historically used for severe achalasia, LHM is increasingly being employed due to its minimally invasive nature and favorable outcomes. This case highlights the potential benefits of LHM in carefully selected patients with severe achalasia, even those with sigmoid esophagus. However, it's important to acknowledge that LHM may not be suitable for all end-stage cases, and esophagectomy might be necessary in some situations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusi\u00f3n:<\/jats:title>\n                    <jats:p>Laparoscopic Heller myotomy with Dor's fundoplication is a promising treatment option for end-stage of achalasia, offering faster recovery and improved quality of life. However, further long-term studies are needed to confirm its long-term effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.110545","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T01:01:19Z","timestamp":1730422879000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Management of end - stage achalasia with laparoscopic Heller myotomy: A case report"],"prefix":"10.1097","volume":"125","author":[{"given":"Diana A.","family":"Pantoja Pachajoa","sequence":"first","affiliation":[{"name":"General Surgery department, Cl\u00ednica Universitaria Reina Fabiola, Universidad Cat\u00f3lica de C\u00f3rdoba, Oncativo 1248, C\u00f3rdoba Capital, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramiro A.","family":"Vargas Aignasse","sequence":"additional","affiliation":[{"name":"General Surgery department, Cl\u00ednica Universitaria Reina Fabiola, Universidad Cat\u00f3lica de C\u00f3rdoba, Oncativo 1248, C\u00f3rdoba Capital, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Alonso Solla","sequence":"additional","affiliation":[{"name":"Servicio Navarro de Salud, C. de Irunlarrea, 31008, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Gielis","sequence":"additional","affiliation":[{"name":"General Surgery department, Cl\u00ednica Universitaria Reina Fabiola, Universidad Cat\u00f3lica de C\u00f3rdoba, Oncativo 1248, C\u00f3rdoba Capital, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan A.","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"General Surgery department, Cl\u00ednica Universitaria Reina Fabiola, Universidad Cat\u00f3lica de C\u00f3rdoba, Oncativo 1248, C\u00f3rdoba Capital, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"German R.","family":"Viscido","sequence":"additional","affiliation":[{"name":"General Surgery department, Cl\u00ednica Universitaria Reina Fabiola, Universidad Cat\u00f3lica de C\u00f3rdoba, Oncativo 1248, C\u00f3rdoba Capital, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"2020","key":"R1-67-20260423","first-page":"180","article-title":"Seoul consensus on esophageal achalasia guidelines","volume":"26","author":"Jung,","year":"2019","journal-title":"J. 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