Skip to main content
Top
Published in: Journal of Gastrointestinal Surgery 4/2012

01-04-2012 | Review Article

Esophageal Achalasia 2011: Pneumatic Dilatation or Laparoscopic Myotomy?

Authors: Marco G. Patti, Carlos A. Pellegrini

Published in: Journal of Gastrointestinal Surgery | Issue 4/2012

Login to get access

Abstract

This article reviews the changes that have taken place in the treatment of patients with achalasia in the last 20 years. It compares and contrasts treatment preferences in the USA with those of Canada and Europe. It provides a critical analysis of the recent randomized trial between laparoscopic Heller myotomy and pneumatic dilatation that was carried out in several European centers. It supports the use of laparoscopic Heller myotomy as the preferred treatment for the average patient with this disease in the USA.
Literature
1.
go back to reference Sauer L. Pellegrini CA, Way LW. The treatment of achalasia. A current perspective. Arch Surg 1989;124:929–932.PubMedCrossRef Sauer L. Pellegrini CA, Way LW. The treatment of achalasia. A current perspective. Arch Surg 1989;124:929–932.PubMedCrossRef
2.
go back to reference Ellis FH, Crozier RE, Watkins E. Operation for esophageal achalasia. Results of esophagomyotomy without an antireflux operation. J Thorac Cardiovasc Surg 1984;88:344–351.PubMed Ellis FH, Crozier RE, Watkins E. Operation for esophageal achalasia. Results of esophagomyotomy without an antireflux operation. J Thorac Cardiovasc Surg 1984;88:344–351.PubMed
3.
go back to reference Abid S, Champion G, Richter JE, McElvein R, Slaughter RL, Koehler RE. Treatment of achalasia: the best of both worlds. Am J Gastroenterol 1994;89:979–985.PubMed Abid S, Champion G, Richter JE, McElvein R, Slaughter RL, Koehler RE. Treatment of achalasia: the best of both worlds. Am J Gastroenterol 1994;89:979–985.PubMed
4.
go back to reference Pellegrini CA, Wetter LA, Patti MG et al. Thoracoscopic esophagomyotomy. Initial experience with a new approach for the treatment of achalasia. Ann Surg 1992;216:291–296.PubMedCrossRef Pellegrini CA, Wetter LA, Patti MG et al. Thoracoscopic esophagomyotomy. Initial experience with a new approach for the treatment of achalasia. Ann Surg 1992;216:291–296.PubMedCrossRef
5.
go back to reference Patti MG, Pellegrini CA, Horgan S et al. Minimally invasive surgery for achalasia. An 8-year experience with 168 patients. Ann Surg 1999;230:587–593.PubMedCrossRef Patti MG, Pellegrini CA, Horgan S et al. Minimally invasive surgery for achalasia. An 8-year experience with 168 patients. Ann Surg 1999;230:587–593.PubMedCrossRef
6.
go back to reference Richards WO, Torquati A, Holzman MD, et al. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia. A prospective, randomized, double-blind clinical trial. Ann Surg 2004;240:405–415.PubMedCrossRef Richards WO, Torquati A, Holzman MD, et al. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia. A prospective, randomized, double-blind clinical trial. Ann Surg 2004;240:405–415.PubMedCrossRef
7.
go back to reference Rebecchi F, Giaccone C, Farinella E, et al. Randomized controlled trial of laparoscopic Heller myotomy plus Dor fundoplication versus Nissen fundoplication for achalasia. Long-term results. Ann Surg 2008;248:1023–1030.PubMedCrossRef Rebecchi F, Giaccone C, Farinella E, et al. Randomized controlled trial of laparoscopic Heller myotomy plus Dor fundoplication versus Nissen fundoplication for achalasia. Long-term results. Ann Surg 2008;248:1023–1030.PubMedCrossRef
8.
go back to reference Rawlings A, Soper NJ, Oelschlager BK, et al. Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia. Results of a multicenter, prospective, randomized-controlled trial. Surg Endosc 2011 (in press). Rawlings A, Soper NJ, Oelschlager BK, et al. Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia. Results of a multicenter, prospective, randomized-controlled trial. Surg Endosc 2011 (in press).
9.
go back to reference Oelchlager BK, Chang L, Pellegrini CA. Improved outcome after extended gastric myotomy for achalasia. Arch Surg 2003;138:490–497.CrossRef Oelchlager BK, Chang L, Pellegrini CA. Improved outcome after extended gastric myotomy for achalasia. Arch Surg 2003;138:490–497.CrossRef
10.
go back to reference Wright AS, Williams CW, Pellegrini CA, Oelschlager BK. Long term outcomes confirm the superior efficacy of extended Heller myotomy with Toupet fundoplication for achalasia. Surg Endosc 2007;21:713–718.PubMedCrossRef Wright AS, Williams CW, Pellegrini CA, Oelschlager BK. Long term outcomes confirm the superior efficacy of extended Heller myotomy with Toupet fundoplication for achalasia. Surg Endosc 2007;21:713–718.PubMedCrossRef
11.
go back to reference Patti MP, Fisichella PM, Perretta S, et al. Impact of minimally invasive surgery on the treatment of esophageal achalasia: A decade of change. J Am Coll Surg 2003; 196:698PubMedCrossRef Patti MP, Fisichella PM, Perretta S, et al. Impact of minimally invasive surgery on the treatment of esophageal achalasia: A decade of change. J Am Coll Surg 2003; 196:698PubMedCrossRef
12.
go back to reference Sweet MP, Nipomnick I, Gasper WJ, et al. The outcome of laparoscopic Heller myotomy for achalasia is not influenced by the degree of esophageal dilatation. J Gastrointest Surg 2008; 12: 159–165.PubMedCrossRef Sweet MP, Nipomnick I, Gasper WJ, et al. The outcome of laparoscopic Heller myotomy for achalasia is not influenced by the degree of esophageal dilatation. J Gastrointest Surg 2008; 12: 159–165.PubMedCrossRef
13.
go back to reference Zaninotto G, Costantini M, Rizzetto C, et al. Four hundred laparoscopic myotomies for esophageal achalasia. Ann Surg 2008; 248: 986–993.PubMedCrossRef Zaninotto G, Costantini M, Rizzetto C, et al. Four hundred laparoscopic myotomies for esophageal achalasia. Ann Surg 2008; 248: 986–993.PubMedCrossRef
14.
go back to reference Rosemurgy AS, Morton CA, Rosas M, et al. A single institution’s experience with more than 500 lapaproscopic Heller myotomies for achalasia. J Am Coll Surg 2010; 210: 637–647.PubMedCrossRef Rosemurgy AS, Morton CA, Rosas M, et al. A single institution’s experience with more than 500 lapaproscopic Heller myotomies for achalasia. J Am Coll Surg 2010; 210: 637–647.PubMedCrossRef
15.
go back to reference Ferri LE, Feldman LS, Stanbridge D, et al. Has the introduction of laparoscopic Heller myotomy altered the treatment paradigm ofachalasia? Can J Gastroenterol 2005;19:619–623.PubMed Ferri LE, Feldman LS, Stanbridge D, et al. Has the introduction of laparoscopic Heller myotomy altered the treatment paradigm ofachalasia? Can J Gastroenterol 2005;19:619–623.PubMed
16.
go back to reference Richter JE, Boeckxstaens GE. Management of achalasia: surgery or pneumatic dilatation. Gut 2011;60:869–876.PubMedCrossRef Richter JE, Boeckxstaens GE. Management of achalasia: surgery or pneumatic dilatation. Gut 2011;60:869–876.PubMedCrossRef
17.
go back to reference Boeckxstaens GE, Annese V, Bruley des Varannes S, et al. Pneumatic dilation versus laparoscopic Heller's myotomy for idiopathic achalasia. N Engl J Med 2011; 364: 1807–16.PubMedCrossRef Boeckxstaens GE, Annese V, Bruley des Varannes S, et al. Pneumatic dilation versus laparoscopic Heller's myotomy for idiopathic achalasia. N Engl J Med 2011; 364: 1807–16.PubMedCrossRef
18.
go back to reference Sharp KW, Khaitan L, Schotz S, et al. One hundred consecutive minimally invasive Heller myotomies: lessons learned. Ann Surg 2002;235:631–639.PubMedCrossRef Sharp KW, Khaitan L, Schotz S, et al. One hundred consecutive minimally invasive Heller myotomies: lessons learned. Ann Surg 2002;235:631–639.PubMedCrossRef
19.
go back to reference Patti MG, Molena D, Fisichella PM, et al. Laparoscopic Heller myotomy and Dor fundoplication for achalasia. Analysis of successes and failures. Arch Surg 2001;136:870–877.PubMedCrossRef Patti MG, Molena D, Fisichella PM, et al. Laparoscopic Heller myotomy and Dor fundoplication for achalasia. Analysis of successes and failures. Arch Surg 2001;136:870–877.PubMedCrossRef
20.
go back to reference Patti MG, Fisichella PM. Laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia. How I do it. J Gastrointest Surg 2008;12:764–766.PubMedCrossRef Patti MG, Fisichella PM. Laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia. How I do it. J Gastrointest Surg 2008;12:764–766.PubMedCrossRef
21.
go back to reference Tatum RP, Pellegrini CA. How I do it: Laparoscopic Heller myotomy and Toupet fundoplication for achalasia. J Gastrointest Surg 2009;13:1120–1124.PubMedCrossRef Tatum RP, Pellegrini CA. How I do it: Laparoscopic Heller myotomy and Toupet fundoplication for achalasia. J Gastrointest Surg 2009;13:1120–1124.PubMedCrossRef
22.
go back to reference West RL, Hirsch DP, Bartelsman JFWM, et al. Long term results of pneumatic dilation in achalasia followed for more than 5 years. Am J Gastroenterol 2002; 97: 1346–1351.PubMedCrossRef West RL, Hirsch DP, Bartelsman JFWM, et al. Long term results of pneumatic dilation in achalasia followed for more than 5 years. Am J Gastroenterol 2002; 97: 1346–1351.PubMedCrossRef
23.
go back to reference Spechler SJ. Pneumatic dilation and laparoscopic Heller's myotomy equally effective for achalasia. NEJM 2011;364:1868–1870.PubMedCrossRef Spechler SJ. Pneumatic dilation and laparoscopic Heller's myotomy equally effective for achalasia. NEJM 2011;364:1868–1870.PubMedCrossRef
24.
25.
go back to reference Portale G, Costantini M, Rizzetto C, et al. Long-term outcome of laparoscopic Heller-Dor surgery for esophageal achalasia: Possible detrimental role of previous endoscopic treatment. J Gastrointest Surg 2005; 9: 1332–1339.PubMedCrossRef Portale G, Costantini M, Rizzetto C, et al. Long-term outcome of laparoscopic Heller-Dor surgery for esophageal achalasia: Possible detrimental role of previous endoscopic treatment. J Gastrointest Surg 2005; 9: 1332–1339.PubMedCrossRef
26.
go back to reference Smith CD, Stival A, Howell L, Swafford V. Endoscopic therapy for achalasia before Heller myotomy results in worse outcomes than Heller myotomy alone. Ann Surg 2006; 243: 579–586.PubMedCrossRef Smith CD, Stival A, Howell L, Swafford V. Endoscopic therapy for achalasia before Heller myotomy results in worse outcomes than Heller myotomy alone. Ann Surg 2006; 243: 579–586.PubMedCrossRef
27.
go back to reference Finley CJ, Kondra J, Clifton J, et al. Factors associated with postoperative symptoms after laparoscopic Heller Myotomy. Ann Thorac Surg 2010; 89: 392–6.PubMedCrossRef Finley CJ, Kondra J, Clifton J, et al. Factors associated with postoperative symptoms after laparoscopic Heller Myotomy. Ann Thorac Surg 2010; 89: 392–6.PubMedCrossRef
28.
go back to reference Farhoomand K, Connor JT, Richter JE, et al. Predictors of outcome of pneumatic dilation in achalasia. Clin Gastroenterol hepatol 2004;2:389–394.PubMedCrossRef Farhoomand K, Connor JT, Richter JE, et al. Predictors of outcome of pneumatic dilation in achalasia. Clin Gastroenterol hepatol 2004;2:389–394.PubMedCrossRef
29.
go back to reference Alderliesten J, Conchillo JM, Leeuwenburgh I, et al. Predictors for outcome failure of ballon dilatation in patients with achalasia. Gut 2011;60:10–16.PubMedCrossRef Alderliesten J, Conchillo JM, Leeuwenburgh I, et al. Predictors for outcome failure of ballon dilatation in patients with achalasia. Gut 2011;60:10–16.PubMedCrossRef
30.
go back to reference Patti MG, Albanese CT, Holcomb GW, et al. Laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia in children. J Pediatric Surg 2001;36:1248–1251.CrossRef Patti MG, Albanese CT, Holcomb GW, et al. Laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia in children. J Pediatric Surg 2001;36:1248–1251.CrossRef
31.
go back to reference Roll GR, Ma S, Gasper WJ, et al. Excellent outcomes of laparoscopic esophagomyotomy for achalasia in patients older than 60 years of age. Surg Endosc 2010;24:2562–2566.PubMedCrossRef Roll GR, Ma S, Gasper WJ, et al. Excellent outcomes of laparoscopic esophagomyotomy for achalasia in patients older than 60 years of age. Surg Endosc 2010;24:2562–2566.PubMedCrossRef
32.
go back to reference Csendes A, Velasco N, Braghetto I, Henriquez A. A prospective randomized study comparing forceful dilatation and esophagomyotomy in patients with achalasia of the esophagus. Gastroenterology 1981;80:789–795.PubMed Csendes A, Velasco N, Braghetto I, Henriquez A. A prospective randomized study comparing forceful dilatation and esophagomyotomy in patients with achalasia of the esophagus. Gastroenterology 1981;80:789–795.PubMed
33.
go back to reference Csendes A, Braghetto I, Henriquez A, Cortes C. Late results of a prospective randomised study comparing forceful dilatation and oesophagomyotomy in patients with achalasia. Gut 1989;30:299–304.PubMedCrossRef Csendes A, Braghetto I, Henriquez A, Cortes C. Late results of a prospective randomised study comparing forceful dilatation and oesophagomyotomy in patients with achalasia. Gut 1989;30:299–304.PubMedCrossRef
34.
go back to reference Kostic S, Kjellin A, Ruth M, et al. Pneumatic dilatation or laparoscopic cardiomyotomy in the management of newly diagnosed idiopathic achalasia. World J Surg 2007:31:470–478.PubMedCrossRef Kostic S, Kjellin A, Ruth M, et al. Pneumatic dilatation or laparoscopic cardiomyotomy in the management of newly diagnosed idiopathic achalasia. World J Surg 2007:31:470–478.PubMedCrossRef
35.
go back to reference Wand L, Li YM, Li L. Meta-analysis of randomized and controlled treatment trials for achalasia. Dig Dis Sci 2009;54:2303–2311.CrossRef Wand L, Li YM, Li L. Meta-analysis of randomized and controlled treatment trials for achalasia. Dig Dis Sci 2009;54:2303–2311.CrossRef
Metadata
Title
Esophageal Achalasia 2011: Pneumatic Dilatation or Laparoscopic Myotomy?
Authors
Marco G. Patti
Carlos A. Pellegrini
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 4/2012
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-011-1694-4

Other articles of this Issue 4/2012

Journal of Gastrointestinal Surgery 4/2012 Go to the issue