“…About one-third of our achalasia patients experienced preoperative heartburn refractory to PPIs and most likely related to stasis, food fermentation, and intraesophageal acidification. 19 In addition, our study confirms that the GERD-HRQL score significantly decreased after operation, indicating that the laparoscopic Heller-Dor operation relieved the outflow obstruction without inducing gastroesophageal reflux. This is in agreement with a meta-analysis of 7,855 patients showing that laparoscopic Heller myotomy combined with fundoplication does reduce the incidence of troublesome postoperative GERD to 8.8%.…”