Redo Heller myotomy vs. POEM after failed Heller myotomy: a systematic review and meta-analysis.
Surg EndoscSep 11, 2026 (epub)
José Barros Sosa, Cristian A Angeramo, Sofía Bertona et al.
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In 30 seconds
This systematic review and meta-analysis compared redo Heller myotomy and peroral endoscopic myotomy (POEM) in 631 patients with recurrent symptoms after laparoscopic Heller myotomy. Both procedures showed similar reductions in Eckardt scores (Redo LHM: 6.64 to 1.22 vs. POEM: 6.71 to 1.82; p=0.57), but POEM had shorter procedural times and lower complication rates.
Key findings
- Both procedures achieved similar overall symptom improvement (Redo LHM: 76% vs. POEM: 82%; p=0.96).
- POEM had a significantly shorter procedural time (89.0 vs. 180.0 min; p<0.001).
- Intraoperative complication rates were lower for POEM (9% vs. 19%; p=0.01).
- Major morbidity was reduced with POEM (4% vs. 11%; p=0.003).
Why it matters
Understanding the comparative effectiveness and safety of redo Heller myotomy versus POEM is crucial for clinicians managing patients with recurrent symptoms after laparoscopic Heller myotomy, as it informs treatment decisions and potential outcomes.