Effectiveness of the Serra Dória Surgery for Patients With Megaesophagus: Historical Cohort and Survey
Bibliographic record
Abstract
Introduction: Esophageal achalasia is a chronic, progressive disease characterized by failure of lower esophageal sphincter relaxation, loss of esophageal peristalsis, and significant impact on quality of life. Its etiology may be primary or secondary, such as in Chagas disease. The estimated incidence is 1 per 100,000 inhabitants. Diagnosis involves upper endoscopy, contrast esophagography, and high-resolution esophageal manometry, which enables functional classification according to the Chicago Classification 4.0 (types I, II, and III). Anatomically, achalasia can be classified into four groups according to Rezende. Therapeutic options include pneumatic dilation, peroral endoscopic myotomy (POEM), Heller cardiomyotomy, and, in advanced cases, esophagectomy. Alternatives such as the Serra Dória surgery have been described with promising results, although evidence remains limited. Objective: To evaluate the effectiveness of Serra Dória surgery in patients with achalasia and megaesophagus. Methods: This is a retrospective cohort study with a patient survey, conducted from July 2025 to July 2026, at Santa Casa de Misericórdia de Goiânia and the University Hospital of the Federal University of Goiás (UFG). Patients aged 18 years or older who underwent Serra Dória surgery for megaesophagus between 2015 and 2024, with a minimum follow-up of one year, will be included. Clinical data will be collected from anonymized and encrypted medical records, and informed consent will be obtained for the survey. The primary outcome will be the Eckardt score, which assesses achalasia symptoms. Statistical analysis will include bivariate tests and binary logistic regression (Eckardt <3 vs ≥3), with significance set at p<0.05. The estimated sample size is 330 patients. Analyses will be performed in R, following STROBE guidelines and the Newcastle–Ottawa Scale. Expected results: The study is expected to identify risk factors associated with better or worse outcomes after Serra Dória surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".