{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:11:07Z","timestamp":1786119067734,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Laparoscopic Heller myotomy is a primary treatment for achalasia, addressing impaired esophageal motility. Fundoplication is typically added to prevent postoperative reflux. This study compares outcomes of limited hiatal dissection without antireflux system in laparoscopic Heller myotomy to Dor fundoplication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 45 patients treated at visceral surgery department (2008-2022). Of these, 29 patients underwent limited hiatal dissection, and 16 underwent Dor fundoplication. A liquid diet was followed on day one, with discharge on day two, and a semi-liquid diet for three weeks. Outcomes included dysphagia resolution, postoperative Eckardt scores &lt;3, and postoperative reflux incidence. The study compared operative and postoperative data between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>The limited hiatal dissection group had a slightly younger mean age (46.97 years) compared to the Dor fundoplication group (51.75 years). The limited hiatal dissection group had a higher proportion of men (58.6 %) while the Dor group had more women (56.3 %). Dysphagia (100 %) and weight loss (68.9 %) were prevalent symptoms. Perioperative complications and hospital stay duration were similar. Operative time was significantly shorter in the limited hiatal dissection group (96.7 vs. 118.3 min, p = 0.004). Both groups showed similar (OR = 0.519, CI = 0.066-4.083) and significant improvement in dysphagia (91.3 % vs. 87.5 %, p &lt; 0.001) with comparable postoperative gastroesophageal disease (20.7 % vs. 25 %, p = 0.726 OR = 1.278, 95 % CI: 0.301-5.420).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Limited hiatal dissection provides comparable symptom relief and reflux prevention, offering a viable alternative to routine antireflux in achalasia treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.111137","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T12:24:22Z","timestamp":1741695862000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Limited hiatal dissection versus Dor-fundoplication in laparoscopic Heller myotomy for achalasia: First experience in Morocco - A case control comparison study"],"prefix":"10.1097","volume":"129","author":[{"given":"Abdelmounaim","family":"Aitali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Othmane","family":"Bourouail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef","family":"Elmahdaouy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abderrahman","family":"Elhjouji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"5","key":"R1-35-20260423","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1007\/s00464-021-08353-w","article-title":"SAGES guidelines committee. Is peroral endoscopic myotomy (POEM) more effective than pneumatic dilation and Heller myotomy? A systematic review and meta-analysis","volume":"35","author":"Dirks,","year":"2021","journal-title":"Surg. Endosc."},{"issue":"1","key":"R2-35-20260423","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s11605-018-3956-x","article-title":"A thousand and one laparoscopic Heller myotomies for esophageal achalasia: a 25-year experience at a single tertiary center","volume":"23","author":"Costantini,","year":"2019","journal-title":"J. Gastrointest. Surg."},{"issue":"5","key":"R3-35-20260423","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1016\/j.athoracsur.2020.06.095","article-title":"Long-term symptom control after laparoscopic Heller myotomy and dor fundoplication for achalasia","volume":"111","author":"Doubova,","year":"2021","journal-title":"Ann. Thorac. Surg."},{"issue":"2","key":"R4-35-20260423","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1097\/00000658-200202000-00005","article-title":"Etiology, diagnosis, and treatment of failures after laparoscopic Heller myotomy for achalasia","volume":"235","author":"Zaninotto,","year":"2002","journal-title":"Ann. Surg."},{"issue":"9","key":"R5-35-20260423","doi-asserted-by":"crossref","DOI":"10.1093\/dote\/doy071","article-title":"The 2018 ISDE Achalasia guidelines","volume":"31","author":"Zaninotto,","year":"2018","journal-title":"Dis. Esophagus"},{"issue":"4","key":"R6-35-20260423","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1007\/s00464-002-8604-5","article-title":"Current status of an antireflux procedure in laparoscopic Heller myotomy","volume":"17","author":"Lyass,","year":"2003","journal-title":"Surg. 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Tech."},{"issue":"3","key":"R10-35-20260423","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s00464-005-0116-7","article-title":"Heller myotomy vs Heller myotomy plus Dor fundoplication: cost-utility analysis of a randomized trial","volume":"20","author":"Torquati,","year":"2006","journal-title":"Surg. Endosc."},{"issue":"7","key":"R11-35-20260423","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1089\/lap.2015.0523","article-title":"Limited hiatal dissection without fundoplication results in comparable symptomatic outcomes to laparoscopic Heller myotomy with anterior fundoplication","volume":"26","author":"DeHaan,","year":"2016","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"issue":"4","key":"R12-35-20260423","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1007\/s11605-009-1135-9","article-title":"Significance of limited hiatal dissection in surgery for achalasia","volume":"14","author":"Simi\u0107,","year":"2010","journal-title":"J. Gastrointest. Surg."},{"key":"R13-35-20260423","doi-asserted-by":"crossref","DOI":"10.1097\/JS9.0000000000000940","article-title":"Preferred reporting of case series in surgery (PROCESS) 2023 guidelines","author":"Mathew,","year":"2023","journal-title":"Int. J. Surg."},{"issue":"1","key":"R14-35-20260423","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s11605-007-0275-z","article-title":"The outcome of laparoscopic Heller myotomy for achalasia is not influenced by the degree of esophageal dilatation","volume":"12","author":"Sweet,","year":"2008","journal-title":"J. Gastrointest. Surg."},{"issue":"2","key":"R15-35-20260423","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/nmo.12477","article-title":"The Chicago Classification of esophageal motility disorders, v3.0","volume":"27","author":"Kahrilas,","year":"2015","journal-title":"Neurogastroenterol. 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Res."},{"issue":"43","key":"R19-35-20260423","doi-asserted-by":"crossref","first-page":"7804","DOI":"10.3748\/wjg.v19.i43.7804","article-title":"Is Dor fundoplication optimum after laparoscopic Heller myotomy for achalasia? A meta-analysis","volume":"19","author":"Wei,","year":"2013","journal-title":"World J. Gastroenterol."},{"issue":"8","key":"R20-35-20260423","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1001\/archsurg.136.8.870","article-title":"Laparoscopic Heller myotomy and Dor fundoplication for achalasia: analysis of successes and failures","volume":"136","author":"Patti,","year":"2001","journal-title":"Arch. Surg."},{"issue":"5","key":"R21-35-20260423","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/s00464-006-9165-9","article-title":"Long-term outcomes confirm the superior efficacy of extended Heller myotomy with Toupet fundoplication for achalasia","volume":"21","author":"Wright,","year":"2007","journal-title":"Surg. 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