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When therapeutic intervention for achalasia fails, a careful evaluation of the cause of the persistent or recurrent symptoms using upper endoscopy, esophageal manometry, and contrast radiologic studies is required to understand the cause of therapy failure and guide plans for subsequent treatment. Options for reintervention are the same as for primary intervention and include pneumatic dilation, botulinum toxin injection, peroral endoscopic myotomy, or redo esophageal myotomy. When reintervention fails or if the esophagus is not amenable to intervention and the disease is considered end\u2010stage, esophagectomy is the last option to manage recurrent achalasia.<\/jats:p>","DOI":"10.1111\/nyas.14440","type":"journal-article","created":{"date-parts":[[2020,7,26]],"date-time":"2020-07-26T18:54:26Z","timestamp":1595789666000},"page":"236-246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Achalasia: what to do in the face of failures of Heller myotomy"],"prefix":"10.1111","volume":"1481","author":[{"given":"Valter N.","family":"Felix","sequence":"first","affiliation":[{"name":"Nucleus of General and Specialized Surgery \u2013 S\u00e3o Paulo and Department of Gastroenterology \u2013 Surgical Division \u2013 S\u00e3o Paulo University FMUSP  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenric M.","family":"Murayama","sequence":"additional","affiliation":[{"name":"Department of Surgery John A. 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