BACKGROUND: The effect of preoperative @entity384 or botulinum toxin injection on outcomes after laparoscopic Heller myotomy (LHM) for @entity1318 is unclear. We compared outcomes in @entity1 with and without multiple preoperative endoscopic interventions. METHODS: This cohort study categorized @entity1318 @entity1 undergoing first-time LHM by the number of preoperative endoscopic interventions: zero or one intervention vs. two or more interventions. Outcomes of interest included surgical failure (defined as the need for re-intervention), @entity344 , and health-related quality of life. Logistic regression modeling was performed to determine the independent effect of multiple preoperative endoscopic interventions on the likelihood of surgical failure. RESULTS: One hundred thirty-four @entity1 were included; 88 (66%) had zero to one preoperative intervention, and 46 (34%) had multiple (more than one) interventions. The incidence of surgical failure was 7% in the zero to one intervention group and 28% in the more than one intervention group (p < 0.01). Greater improvements in @entity344 and health-related quality of life were seen in the zero to one intervention group. On logistic regression modeling, the likelihood of surgical failure was significantly higher in the more than one intervention group (odds ratio = 5.1, 95% confidence interval 1.6-15.8, p = 0.005). CONCLUSIONS: Multiple endoscopic treatments are associated with poorer outcomes and should be limited to @entity1318 @entity1 who fail surgical therapy.

Multiple preoperative endoscopic interventions are associated with worse outcomes after laparoscopic Heller myotomy for XXXX .

@entity1318 :: ('MESH:D004931', 'Disease') :: ['achalasia'] @entity384 :: ('MESH:D002311', 'Disease') :: ['pneumatic dilation'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity344 :: ('MESH:D005767', 'Disease') :: ['gastrointestinal symptoms']
@entity1318 :: (MESH:D004931,Disease) :: ['achalasia']
