Is routine surveillance with periodic barium esophagram or endoscopic reassessment indicated in asymptomatic patients more than 20 years after Heller myotomy for achalasia?

While the most recent guidelines from Vaezi et al., PMID 32773454, recommend against routine endoscopic surveillance for esophageal carcinoma in patients with achalasia, they also acknowledge that many experts do favor endoscopic or radiographic surveillance at an interval of ~ every 3 years, if the...

Yes, because patients with previously treated achalasia can silently or subclinically progress. I do a barium esophagram every 2-3 years in my patients with treated achalasia.