Laparoscopic Heller Myotomy versus Per Oral Endoscopic Myotomy: Evidence-Based Approach to the Treatment of Esophageal Achalasia.

Abstract

Esophageal achalasia is a rare disorder characterized by a failure of the lower esophageal sphincter to relax during swallowing, combined with aperistalsis of the esophageal body. Treatment is not curative, but aims to eliminate the outflow resistance caused by the nonrelaxing lower esophageal sphincter. Current evidence suggests that both laparoscopic Heller myotomy and per oral endoscopic myotomy (POEM) are very effective in the relief of symptoms in patients with achalasia. Specifically, for type III achalasia, POEM may achieve higher success rates. However, POEM is associated to a very high incidence of pathologic reflux, with the risk of exchanging one disease-achalasia-with another-gastroesophageal reflux.

• Authors: Francisco Schlottmann, Marco G Patti
• Journal: The American surgeon (Am Surg) Vol. 84 Issue 4 Pg. 496-500 (Apr 01 2018) ISSN: 1555-9823 [Electronic] United States
• PMID: 29712595 (Publication Type: Journal Article, Review)

Topics

• Esophageal Achalasia (surgery)
• Fundoplication (methods)
• Gastroesophageal Reflux (etiology, prevention & control)
• Heller Myotomy (methods)
• Humans
• Laparoscopy (methods)
• Natural Orifice Endoscopic Surgery (methods)
• Postoperative Complications (prevention & control)
• Treatment Outcome