{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T09:16:10Z","timestamp":1784020570994,"version":"3.55.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Laparoscopic Heller's myotomy (LHM), per oral endoscopic myotomy, and pneumatic dilatation are well-established methods to treat achalasia. The ideal treatment algorithm in elderly patients is, however, still elusive. This multicenter study aims to evaluate outcomes and changes in routine therapeutic options in patients &gt;80 years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Worldwide high-volume centers for the treatment of achalasia were surveyed. Therapeutic options and outcomes in patients &gt;80 years of age were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eighty-five (54% men, mean age 84\u2009\u00b1\u20094 years) patients were studied. Primary treatment was endoscopic in 43 (51%) patients, surgical in 39 (46%) patients (30 LHM, 9 cardioplasty\u2009+\u2009gastrectomy), and medical in 3 (4%) patients. Four centers tailored treatment based on age (14% of the patients). Secondary treatment was necessary in 34 (40%) patients: 30 of them with endoscopic treatment as primary treatment. LHM was performed in 20 patients and endoscopic treatment in 14 patients. A total of 11 (13%) patients had complications after LHM. Seven had LHM or cardioplasty\u2009+\u2009gastrectomy as primary treatment. Four had LHM as secondary treatment. The mean time of hospitalization was 4\u2009\u00b1\u20092 days for those who did not have complications, and 7\u2009\u00b1\u20096 days for those who had complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Most specialized centers do not tailor treatment based on advanced age. Treatment of the oldest-old patients should be based solely on their physiologic and mental health, not their age. Endoscopic treatment has a high rate of recurrence and gastrectomy a high rate of complications in his population. LHM seems to be a safe option with good outcomes in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lap.2019.0749","type":"journal-article","created":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T16:28:53Z","timestamp":1580228933000},"page":"358-362","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Achalasia Treatment in Patients over 80 Years of Age: A Multicenter Survey"],"prefix":"10.1177","volume":"30","author":[{"given":"Orlando R.","family":"Zotti","sequence":"first","affiliation":[{"name":"Department of Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando A.M.","family":"Herbella","sequence":"additional","affiliation":[{"name":"Department of Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscila R.","family":"Armijo","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Nebraska, Omaha, Nebraska."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry","family":"Oleynikov","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Nebraska, Omaha, Nebraska."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 L.","family":"Aquino","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catholic University of Campinas, Campinas, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vania A.","family":"Leandro-Merhi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catholic University of Campinas, Campinas, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vic","family":"Velanovich","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of South Florida, Tampa, Florida."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Salvador","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Padua, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Costantini","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Padua, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Virginia Mason Medical Center, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Wirsching","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Virginia Mason Medical Center, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piers R.","family":"Boshier","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Virginia Mason Medical Center, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Kristem","sequence":"additional","affiliation":[{"name":"Department of Surgery, Federal University of Rio Grande do Sul, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard R.","family":"Gurski","sequence":"additional","affiliation":[{"name":"Department of Surgery, Federal University of Rio Grande do Sul, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco G.","family":"Patti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of North Carolina, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,4,16]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i35.5806"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1067\/j.cpsurg.2018.01.001"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00123-5"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.4923"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000212"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.24.11.1020"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000199661"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91428-7"},{"key":"e_1_3_4_10_2","first-page":"1","article-title":"Complications of botulinum toxin injections for treatment of esophageal motility disorders\u2020","volume":"30","author":"Van Hoeij FB","year":"2017","unstructured":"Van Hoeij FB, , Tack JF, , Pandolfino JE, , Sternbach JM, , Roman S, , Smout AJ, , Bredenoord AJ. 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