Clinical results of Heller myotomy using the Eckardt scale over a 5-year period: A single-center retrospective cohort study

Achalasia is a primary esophageal motility disorder with an incidence of approximately 1 per 100,000 people per year, most frequently affecting individuals under 30 and over 50 years of age. In Latin America, evidence on the long-term outcomes of surgical treatment remains limited. This study aimed to evaluate the clinical response to laparoscopic Heller myotomy with Dor fundoplication using the Eckardt scale over a 5-year period at a tertiary care center in Colombia. A single-center retrospective cohort study was conducted, including 58 patients with achalasia who underwent laparoscopic Heller myotomy with anterior Dor fundoplication at Clínica Universitaria Colombia between January 2018 and May 2023. Clinical and perioperative data were collected from medical records, and postoperative symptoms were evaluated with the Eckardt scale during follow-up telephone interviews. Fifty-eight patients were included, with a mean age of 44 years; 70.7% were women. According to the Chicago classification, 67.2% had type II achalasia. The mean operative time was 103 minutes, and the mean hospital stay was 1.2 days. Complications occurred in 10.3% of patients, most of them minor (Clavien–Dindo grade I). The mean postoperative Eckardt score was 2.4 (±1.8); 84.5% of patients were classified as stages I–II, while 15.5% were stages III–IV. Seven patients (12.1%) experienced clinical recurrence, managed with medical therapy or endoscopic dilation. There was no surgery-related mortality. Laparoscopic Heller myotomy with Dor fundoplication proved to be safe and effective, with more than 80% of patients achieving symptom improvement and a low rate of complications. Although limited by its retrospective single-center design, this study provides valuable regional evidence on achalasia outcomes in Colombia and supports the need for future multicenter research to validate these findings and compare surgical results with alternative therapies.