Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.


Endoscopic myotomy non-inferior to surgical myotomy for idiopathic achalasia

Current treatment options for achalasia include endoscopic pneumatic dilation and surgical laparoscopic Heller’s myotomy (LHM). A multicentre, randomized trial compared LHM plus Dor’s fundoplication with the less-invasive peroral endoscopic myotomy (POEM) in patients with idiopathic achalasia. The primary endpoint of clinical success at the 2-year follow-up was observed in 83.0% of the 112 patients undergoing POEM and 81.7% of the 109 patients undergoing LHM plus Dor’s fundoplication. Thus, POEM was non-inferior to LHM plus Dor’s fundoplication (P = 0.007 for non-inferiority). 44% of patients who underwent POEM and 29% of patients who underwent LHM plus Dor’s fundoplication had reflux oesophagitis at the 2-year follow-up.


Original article

  • Werner, Y. B. et al. Endoscopic or surgical myotomy in patients with idiopathic achalasia. N. Engl. J. Med. 381, 2219–2229 (2019)

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Jordan Hindson.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Hindson, J. Endoscopic myotomy non-inferior to surgical myotomy for idiopathic achalasia. Nat Rev Gastroenterol Hepatol 17, 66 (2020).

Download citation

  • Published:

  • Issue Date:

  • DOI:


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing