Comparison of outcomes following open and laparoscopic esophagomyotomy for achalasia

Abstract

Laparoscopic esophagomyotomy for achalasia results in symptomatic improvement and high patient satisfaction comparable to the open procedure but with significantly less morbidity.

Laparoscopic Heller Cardiomyotomy and Dor Fundoplication for Esophageal Achalasia

“…These results are similar to those reported by other researchers, 3,4,[7][8][9]13 although patients with stage IV were usually excluded from these series. It is widely accepted that advanced disease does not respond to myotomy, and that esophagectomy should be offered to these patients first.…”

“…6 More recently, minimally invasive esophagomyotomy by laparoscopy is replacing open surgery for achalasia, but data comparing these 2 different approaches are sparse. Data from small series 7 show similar results concerning relief of dysphagia and satisfaction of the patient with the outcome after either approach. The laparoscopic approach is associated with significantly less blood loss, parenteral narcotic use, hospitalization time, and time off work.…”

“…[2][3][4][7][8][9]12,13 In a large series by Patti et al, 14 100 of 112 patients who underwent laparoscopic Heller myotomy and partial fundoplication had good or excellent results. At postoperative functional evaluation in 35 of those patients, reflux was present in 17%, and the mean LES pressure decreased from 28 mm Hg before surgery to 10 mm Hg after surgery.…”

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

“…Although the study included only 26 patients, they were able to detect significant differences: six weeks after the operation, the laparoscopic group scored better on the subscales reflecting physical functioning, role-physical, and vitality. Dempsey et al [24] used an ad hoc questionnaire that covered all domains of QoL (2b). The study examined the postoperative course of 22 patients over a 16 month follow-up.…”

Current status of an antireflux procedure in laparoscopic Heller myotomy

“…The application of a minimal access technique to the proven results of myotomy has led many surgeons and gastroenterologists to recommend surgery as the primary treatment [6,21,28]. Initially, controversy existed regarding whether laparoscopy or thoracoscopy provided the optimal approach.…”