{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:46:48Z","timestamp":1787071608431,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Laparoscopic Heller myotomy (LHM) is the preferred treatment approach to reducing lower oesophageal sphincter pressure (LOSP). However, less than half of the patients show high LOSP. This study primarily aims to evaluate how LOSP affects operative results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>\n                      From 2019 to 2023, a total of 52 patients were treated with LHM combined with partial fundoplication, diagnosed by integrated relaxing pressure (IRP) &gt;15 mmHg on high-resolution manometry (HRM). Based on HRM, patients were assigned into two arms: normal LOSP (\u226435 mmHg,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 30) and high LOSP (&gt;35 mmHg,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 22). Symptoms were assessed preoperatively, and the median duration of follow-up of 24 months using the Eckardt score (ES), the achalasia-specific quality of life (ASQ) score and the SF-36 questionnaire quality of Life (QOL). Treatment failure was defined as ES \u22654 or an ASQ score \u226516.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Pre-operative Eckardt and ASQ scores were similar between groups. The high LOSP group had significantly younger populations (\u226450 years: 90.90% vs. 60%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.013). The normal LOSP group had significantly less dysphagia (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.007) and regurgitation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.011), reflecting significantly lower post-operative ES (0.80 vs. 2.00,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002). In addition, post-operative ASQ scores (11 vs. 14,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005) and QOL were significantly better in the normal LOSP group. The high LOSP group experienced a significantly greater failure rate (31.80% vs. 6.7%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.027).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Normal LOSP results in better surgical outcomes and QOL, as younger patients with high LOSP have poorer responses, due to higher LOS muscle tone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_247_25","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T10:00:09Z","timestamp":1763978409000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Impact of lower oesophageal sphincter pressure on surgical outcomes in achalasia cardia: A comparative study"],"prefix":"10.4103","author":[{"given":"Utpal","family":"Anand","sequence":"first","affiliation":[{"name":"Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijit","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal","family":"Parasar","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basant Narayan","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kislay","family":"Kant","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohith","family":"Kodali","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"R1-20251201","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/j.1572-0241.2003.07266.x","article-title":"Correlation between clinical severity score and the lower esophageal sphincter relaxation pressure in idiopathic achalasia","volume":"98","author":"Yaghoobi","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"R2-20251201","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.3390\/diagnostics13061136","article-title":"Correlation between lower esophageal sphincter metrics on high-resolution manometry and the clinical presentation of patients with newly diagnosed achalasia","volume":"13","author":"Cohen","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"R3-20251201","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/00000478-199404000-00001","article-title":"Achalasia. 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