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Published in: Journal of Gastrointestinal Surgery 2/2017

01-02-2017 | SSAT

POEM vs Laparoscopic Heller Myotomy and Fundoplication: Which Is Now the Gold Standard for Treatment of Achalasia?

Authors: Marco G. Patti, Ciro Andolfi, Steven P. Bowers, Nathaniel J. Soper

Published in: Journal of Gastrointestinal Surgery | Issue 2/2017

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Excerpt

Achalasia is a rare idiopathic disease of esophageal motility characterized by a failure of the esophageal gastric junction (EGJ) to relax during swallowing, combined with aperistalsis of the esophageal body. The lower esophageal sphincter (LES) is hypertensive in about 50 % of patients.1 Dysphagia, regurgitation, retrosternal pain, heartburn, respiratory symptoms, and weight loss are the most common symptoms,1 and esophageal dilation and tortuosity ultimately develop over time without treatment. …
Literature
1.
go back to reference Fisichella PM, Raz D, Palazzo F, Niponmick I, Patti MG. Clinical, radiological, and manometric profile in 145 patients with untreated achalasia. World J Surg. 2008;32(9):1974-9.CrossRefPubMed Fisichella PM, Raz D, Palazzo F, Niponmick I, Patti MG. Clinical, radiological, and manometric profile in 145 patients with untreated achalasia. World J Surg. 2008;32(9):1974-9.CrossRefPubMed
2.
go back to reference Samo S, Carlson DA, Gregory DL, Gawel SH, Pandolfino JE, Kahrilas PJ. Incidence and Prevalence of Achalasia in Central Chicago, 2004-2014, Since the Widespread use of High Resolution Manometry. Clinical Gastroenterology and Hepatology, 2016. doi:10.1016/j.cgh.2016.08.030.PubMed Samo S, Carlson DA, Gregory DL, Gawel SH, Pandolfino JE, Kahrilas PJ. Incidence and Prevalence of Achalasia in Central Chicago, 2004-2014, Since the Widespread use of High Resolution Manometry. Clinical Gastroenterology and Hepatology, 2016. doi:10.​1016/​j.​cgh.​2016.​08.​030.PubMed
3.
go back to reference Bredenord AJ, Fox M, Kahrilas PJ, et al. Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal motility pressure topography. Neurogastroenterol Motil 2012;24:157-165. Bredenord AJ, Fox M, Kahrilas PJ, et al. Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal motility pressure topography. Neurogastroenterol Motil 2012;24:157-165.
4.
go back to reference Wang YR, Dempsey DT, Friedenberg FK, Richter JE. Trends of Heller Myotomy Hospitalizations for Achalasia in the United States, 1993-2005: Effect of Surgical Volume on Perioperative Outcomes. Am J Gastroenterol 2008:103:2454-2464.CrossRefPubMed Wang YR, Dempsey DT, Friedenberg FK, Richter JE. Trends of Heller Myotomy Hospitalizations for Achalasia in the United States, 1993-2005: Effect of Surgical Volume on Perioperative Outcomes. Am J Gastroenterol 2008:103:2454-2464.CrossRefPubMed
5.
go back to reference Bhayani NH, Kurian AA, Dunst CM, Sharata AM, Rieder E, Swanstrom LL. A comparative study on comprehensive, objective outcomes of laparoscopic Heller myotomy with per-oral endoscopic myotomy (POEM) for achalasia. Ann Surg 2014;259:1098-1103.CrossRefPubMed Bhayani NH, Kurian AA, Dunst CM, Sharata AM, Rieder E, Swanstrom LL. A comparative study on comprehensive, objective outcomes of laparoscopic Heller myotomy with per-oral endoscopic myotomy (POEM) for achalasia. Ann Surg 2014;259:1098-1103.CrossRefPubMed
6.
go back to reference El Khoury R, Teitelbaum EN, Sternbach JM, Soper NJ, Harmath CB, Pandolfino JE, Kahrilas PJ, Hungness ES. Evaluation of the need for routine esophagram after peroral endoscopic myotomy (POEM). Surg Endosc epub online 20 Oct 2015. El Khoury R, Teitelbaum EN, Sternbach JM, Soper NJ, Harmath CB, Pandolfino JE, Kahrilas PJ, Hungness ES. Evaluation of the need for routine esophagram after peroral endoscopic myotomy (POEM). Surg Endosc epub online 20 Oct 2015.
7.
go back to reference Jones EL, Meara MP, Pittman MR, Hazey JW, Perry KA. Prior treatment does not influence the performance or early outcome of per-oral endoscopic myotomy for achalasia. Surg Endosc 2016;30:1282-1286.CrossRefPubMed Jones EL, Meara MP, Pittman MR, Hazey JW, Perry KA. Prior treatment does not influence the performance or early outcome of per-oral endoscopic myotomy for achalasia. Surg Endosc 2016;30:1282-1286.CrossRefPubMed
8.
go back to reference Kashab MA, Zein ME, Kumbhari V, Besharati S, Ngamruengphong S, et al. Comprehensive analysis of efficacy and safety of peroral endoscopic myotomy performed by gastroenterologist in the endoscopy unti: a single center experience. Gastrointest Endosc 2016:83:117-25.CrossRef Kashab MA, Zein ME, Kumbhari V, Besharati S, Ngamruengphong S, et al. Comprehensive analysis of efficacy and safety of peroral endoscopic myotomy performed by gastroenterologist in the endoscopy unti: a single center experience. Gastrointest Endosc 2016:83:117-25.CrossRef
9.
go back to reference Miereles OR, Horgan S, Jacobsen GR, Katagiri T, Mathew A, Sedrak M, Sandler BJ, Dotai T, Savides TJ, Majiki SF, Nijhawan S, Talamini MA. Treansesophageal endoscopic myotomy (TEEM) for the treatment of achalasia: the United States human experience. Surg Endosc 2013;27:1803-1809.CrossRef Miereles OR, Horgan S, Jacobsen GR, Katagiri T, Mathew A, Sedrak M, Sandler BJ, Dotai T, Savides TJ, Majiki SF, Nijhawan S, Talamini MA. Treansesophageal endoscopic myotomy (TEEM) for the treatment of achalasia: the United States human experience. Surg Endosc 2013;27:1803-1809.CrossRef
10.
go back to reference Orenstein SB, Raigani S, Wu YV, Pauli EM, Phillips MS, Ponsky JL, Marks JM. Peroral endoscopic myotomy (POEM) leads to similar results in patients with and without prior endoscopic or surgical therapy. Surg Endosc 2015;29:1064-1070.CrossRefPubMed Orenstein SB, Raigani S, Wu YV, Pauli EM, Phillips MS, Ponsky JL, Marks JM. Peroral endoscopic myotomy (POEM) leads to similar results in patients with and without prior endoscopic or surgical therapy. Surg Endosc 2015;29:1064-1070.CrossRefPubMed
11.
go back to reference Patel KS, Calizte R, Modayil RJ, Friedel D, Brathwaite CE, Stavropoulos SN. The light at the end of the tunnel: a single-operator learning curve analysis for per oral endoscopic myotomy. Gastrointest Endosc 2015;81:1181-7.CrossRefPubMed Patel KS, Calizte R, Modayil RJ, Friedel D, Brathwaite CE, Stavropoulos SN. The light at the end of the tunnel: a single-operator learning curve analysis for per oral endoscopic myotomy. Gastrointest Endosc 2015;81:1181-7.CrossRefPubMed
12.
go back to reference Phillips GM, Dacha S, Keilin SA, Willingham FF, Cai Q. Concurrent myotomy and tunneling after establishment of a half tunnel instead of myotomy after establishment of a full tunnel: a more efficient method of peroral endoscopic myotomy. Endoscopy International Open 2016:04:E403-408.CrossRef Phillips GM, Dacha S, Keilin SA, Willingham FF, Cai Q. Concurrent myotomy and tunneling after establishment of a half tunnel instead of myotomy after establishment of a full tunnel: a more efficient method of peroral endoscopic myotomy. Endoscopy International Open 2016:04:E403-408.CrossRef
13.
go back to reference Vigneswaran Y, Tanaka R, Gitells, Carbray J, Ujiki MB. Quality of life assessment after peroral endoscopic myotomy. Surg Endosc 2015;29(1):1198-1202.CrossRefPubMed Vigneswaran Y, Tanaka R, Gitells, Carbray J, Ujiki MB. Quality of life assessment after peroral endoscopic myotomy. Surg Endosc 2015;29(1):1198-1202.CrossRefPubMed
14.
go back to reference Worrell SG, Alicuben ET, Boys J, DeMeester SR. Peroral endoscopic myotomy for achalasia in a thoracic surgical practice. Ann Thorac Surg 2016;101:218-225.CrossRefPubMed Worrell SG, Alicuben ET, Boys J, DeMeester SR. Peroral endoscopic myotomy for achalasia in a thoracic surgical practice. Ann Thorac Surg 2016;101:218-225.CrossRefPubMed
15.
go back to reference Yang D, Pannu D, Zhang Q, White J, Draganov PV. Evaluation of anesthesia management, feasibility and efficacy of peroral endoscopic myotomy (POEM) for achalasia performed in the endoscopy unit. Endosc International Open 2015;03:E289-E295.CrossRef Yang D, Pannu D, Zhang Q, White J, Draganov PV. Evaluation of anesthesia management, feasibility and efficacy of peroral endoscopic myotomy (POEM) for achalasia performed in the endoscopy unit. Endosc International Open 2015;03:E289-E295.CrossRef
16.
go back to reference Pellegrini C, Wetter LA, Patti M, Leichter R, Mussan G, Mori T, et al. Thoracoscopic esophagomyotomy. Initial experience with a new approach for the treatment of achalasia. Ann Surg. 1992;216(3):291-6; discussion 6-9.CrossRefPubMedPubMedCentral Pellegrini C, Wetter LA, Patti M, Leichter R, Mussan G, Mori T, et al. Thoracoscopic esophagomyotomy. Initial experience with a new approach for the treatment of achalasia. Ann Surg. 1992;216(3):291-6; discussion 6-9.CrossRefPubMedPubMedCentral
17.
18.
go back to reference Patti MG, Arcerito M, De Pinto M, Feo CV, Tong J, Gantert W, et al. Comparison of thoracoscopic and laparoscopic Heller myotomy for achalasia. J Gastrointest Surg. 1998;2(6):561-6.CrossRefPubMed Patti MG, Arcerito M, De Pinto M, Feo CV, Tong J, Gantert W, et al. Comparison of thoracoscopic and laparoscopic Heller myotomy for achalasia. J Gastrointest Surg. 1998;2(6):561-6.CrossRefPubMed
19.
go back to reference Richards WO, Torquati A, Holzman MD, Khaitan L, Byrne D, Lutfi R, et al. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial. Ann Surg. 2004;240(3):405-12; discussion 12-5.CrossRefPubMedPubMedCentral Richards WO, Torquati A, Holzman MD, Khaitan L, Byrne D, Lutfi R, et al. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial. Ann Surg. 2004;240(3):405-12; discussion 12-5.CrossRefPubMedPubMedCentral
20.
go back to reference Rebecchi F, Giaccone C, Farinella E, Campaci R, Morino M. Randomized controlled trial of laparoscopic Heller myotomy plus Dor fundoplication versus Nissen fundoplication for achalasia: long-term results. Ann Surg. 2008;248(6):1023-30.CrossRefPubMed Rebecchi F, Giaccone C, Farinella E, Campaci R, Morino M. Randomized controlled trial of laparoscopic Heller myotomy plus Dor fundoplication versus Nissen fundoplication for achalasia: long-term results. Ann Surg. 2008;248(6):1023-30.CrossRefPubMed
21.
go back to reference Novais PA, Lemme EM. 24-h pH monitoring patterns and clinical response after achalasia treatment with pneumatic dilation or laparoscopic Heller myotomy. Aliment Pharmacol Ther. 2010;32(10):1257-65.CrossRefPubMed Novais PA, Lemme EM. 24-h pH monitoring patterns and clinical response after achalasia treatment with pneumatic dilation or laparoscopic Heller myotomy. Aliment Pharmacol Ther. 2010;32(10):1257-65.CrossRefPubMed
22.
go back to reference Salvador R, Costantini M, Pesenti E, Gobbi L, Spadotto L, Voltarel G, Cavallin F, Nicoletti L, Capovilla G, Merigliano S. Post-operative gastroesophageal reflux after laparoscopic Heller-Dor for achalasia: true incidence with an objective evaluation. SSAT 2016 Annual Meeting. Salvador R, Costantini M, Pesenti E, Gobbi L, Spadotto L, Voltarel G, Cavallin F, Nicoletti L, Capovilla G, Merigliano S. Post-operative gastroesophageal reflux after laparoscopic Heller-Dor for achalasia: true incidence with an objective evaluation. SSAT 2016 Annual Meeting.
23.
go back to reference Campos GM, Vittinghoff E, Rabl C, Takata M, Gadenstatter M, Lin F, et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg. 2009;249(1):45-57.CrossRefPubMed Campos GM, Vittinghoff E, Rabl C, Takata M, Gadenstatter M, Lin F, et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg. 2009;249(1):45-57.CrossRefPubMed
24.
go back to reference Rawlings A, Soper NJ, Oelschlager B, Swanstrom L, Matthews BD, Pellegrini C, et al. Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia: results of a multicenter, prospective, randomized-controlled trial. Surg Endosc. 2012;26(1):18-26.CrossRefPubMed Rawlings A, Soper NJ, Oelschlager B, Swanstrom L, Matthews BD, Pellegrini C, et al. Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia: results of a multicenter, prospective, randomized-controlled trial. Surg Endosc. 2012;26(1):18-26.CrossRefPubMed
25.
go back to reference Perrone JM, Frisella MM, Desai KM, Soper NJ. Results of laparoscopic Heller-Toupet operation for achalasia. Surg Endosc. 2004;18(11):1565-71.CrossRefPubMed Perrone JM, Frisella MM, Desai KM, Soper NJ. Results of laparoscopic Heller-Toupet operation for achalasia. Surg Endosc. 2004;18(11):1565-71.CrossRefPubMed
26.
go back to reference Patti MG, Gorodner MV, Galvani C, Tedesco P, Fisichella PM, Ostroff JW, et al. Spectrum of esophageal motility disorders: implications for diagnosis and treatment. Arch Surg. 2005;140(5):442-8; discussion 8-9.CrossRefPubMed Patti MG, Gorodner MV, Galvani C, Tedesco P, Fisichella PM, Ostroff JW, et al. Spectrum of esophageal motility disorders: implications for diagnosis and treatment. Arch Surg. 2005;140(5):442-8; discussion 8-9.CrossRefPubMed
27.
go back to reference Khajanchee YS, Kanneganti S, Leatherwood AE, Hansen PD, Swanstrom LL. Laparoscopic Heller myotomy with Toupet fundoplication: outcomes predictors in 121 consecutive patients. Arch Surg. 2005;140(9):827-33; discussion 33-4.CrossRefPubMed Khajanchee YS, Kanneganti S, Leatherwood AE, Hansen PD, Swanstrom LL. Laparoscopic Heller myotomy with Toupet fundoplication: outcomes predictors in 121 consecutive patients. Arch Surg. 2005;140(9):827-33; discussion 33-4.CrossRefPubMed
28.
go back to reference Rosen MJ, Novitsky YW, Cobb WS, Kercher KW, Heniford BT. Laparoscopic Heller myotomy for achalasia in 101 patients: can successful symptomatic outcomes be predicted? Surg Innov. 2007;14(3):177-83.CrossRefPubMed Rosen MJ, Novitsky YW, Cobb WS, Kercher KW, Heniford BT. Laparoscopic Heller myotomy for achalasia in 101 patients: can successful symptomatic outcomes be predicted? Surg Innov. 2007;14(3):177-83.CrossRefPubMed
29.
go back to reference Zaninotto G, Costantini M, Rizzetto C, Zanatta L, Guirroli E, Portale G, et al. Four hundred laparoscopic myotomies for esophageal achalasia: a single centre experience. Ann Surg. 2008;248(6):986-93.CrossRefPubMed Zaninotto G, Costantini M, Rizzetto C, Zanatta L, Guirroli E, Portale G, et al. Four hundred laparoscopic myotomies for esophageal achalasia: a single centre experience. Ann Surg. 2008;248(6):986-93.CrossRefPubMed
30.
go back to reference Rosemurgy AS, Morton CA, Rosas M, Albrink M, Ross SB. A single institution’s experience with more than 500 laparoscopic Heller myotomies for achalasia. J Am Coll Surg. 2010;210(5):637-45, 45-7.CrossRefPubMed Rosemurgy AS, Morton CA, Rosas M, Albrink M, Ross SB. A single institution’s experience with more than 500 laparoscopic Heller myotomies for achalasia. J Am Coll Surg. 2010;210(5):637-45, 45-7.CrossRefPubMed
31.
go back to reference Nau P, Rattner D. Laparoscopic Heller myotomy as the gold standard for treatment of achalasia. J Gastrointest Surg. 2014;18(12):2201-7.CrossRefPubMed Nau P, Rattner D. Laparoscopic Heller myotomy as the gold standard for treatment of achalasia. J Gastrointest Surg. 2014;18(12):2201-7.CrossRefPubMed
32.
go back to reference Persson J, Johnsson E, Kostic S, Lundell L, Smedh U. Treatment of achalasia with laparoscopic myotomy or pneumatic dilatation: long-term results of a prospective, randomized study. World J Surg. 2015;39(3):713-20.CrossRefPubMed Persson J, Johnsson E, Kostic S, Lundell L, Smedh U. Treatment of achalasia with laparoscopic myotomy or pneumatic dilatation: long-term results of a prospective, randomized study. World J Surg. 2015;39(3):713-20.CrossRefPubMed
33.
go back to reference Moonen A, Annese V, Belmans A, Bredenoord AJ, Bruley des Varannes S, Costantini M, et al. Long-term results of the European achalasia trial: a multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy. Gut. 2016;65(5):732-9.CrossRefPubMed Moonen A, Annese V, Belmans A, Bredenoord AJ, Bruley des Varannes S, Costantini M, et al. Long-term results of the European achalasia trial: a multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy. Gut. 2016;65(5):732-9.CrossRefPubMed
34.
go back to reference Patti MG, Allaix ME. Recurrent symptoms after Heller myotomy for achalasia: evaluation and treatment. World J Surg. 2015;39(7):1625-30.CrossRefPubMed Patti MG, Allaix ME. Recurrent symptoms after Heller myotomy for achalasia: evaluation and treatment. World J Surg. 2015;39(7):1625-30.CrossRefPubMed
35.
go back to reference Rawlings A, Soper NJ, Oelschlager B, et al. Laparoscopic Dor vs. Toupet fundoplication following Heller myotomy for achalasia: Results of a multi-center, prospective, randomized controlled trial. Surg Endosc 2012; 26: 18-26.CrossRefPubMed Rawlings A, Soper NJ, Oelschlager B, et al. Laparoscopic Dor vs. Toupet fundoplication following Heller myotomy for achalasia: Results of a multi-center, prospective, randomized controlled trial. Surg Endosc 2012; 26: 18-26.CrossRefPubMed
36.
go back to reference Veenstra BR, Goldberg RF, Bowers SP, et al. Revisional surgery after failed esophagogastric myotomy for achalasia: successful esophageal preservation. Surg Endosc 2016;30(5):1754-1761.CrossRefPubMed Veenstra BR, Goldberg RF, Bowers SP, et al. Revisional surgery after failed esophagogastric myotomy for achalasia: successful esophageal preservation. Surg Endosc 2016;30(5):1754-1761.CrossRefPubMed
37.
go back to reference Inoue H, Minami H, Kobayashi Y, Sato Y, Kaga M, Suzuki M, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42(4):265-71.CrossRefPubMed Inoue H, Minami H, Kobayashi Y, Sato Y, Kaga M, Suzuki M, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42(4):265-71.CrossRefPubMed
38.
go back to reference Marano L, Pallabazzer G, Solito B, et al. Surgery or peroral esophageal myotomy for achalasia: A systematic review and meta-analysis. Medicine 2016; 95: 1-9.CrossRef Marano L, Pallabazzer G, Solito B, et al. Surgery or peroral esophageal myotomy for achalasia: A systematic review and meta-analysis. Medicine 2016; 95: 1-9.CrossRef
39.
go back to reference Hungness ES, Sternbach JM, Teitelbaum EN, et al. Per-Oral Esophageal Myotomy (POEM) after the learning curve: Durable long-term results with a low complication rate. Presented at the American Surgical Association April, 2016; in press, Ann Surg. Hungness ES, Sternbach JM, Teitelbaum EN, et al. Per-Oral Esophageal Myotomy (POEM) after the learning curve: Durable long-term results with a low complication rate. Presented at the American Surgical Association April, 2016; in press, Ann Surg.
40.
go back to reference Kumbari V, Tieu AH, Onimaru M, et al. Peroral endoscopic myotomy (POEM) vs laparoscopic Heller myotomy (LHM) for the treatment of type III achalasia in 75 patients: a multicenter comparative study. Endosc International Open 2015;03:E195-201.CrossRef Kumbari V, Tieu AH, Onimaru M, et al. Peroral endoscopic myotomy (POEM) vs laparoscopic Heller myotomy (LHM) for the treatment of type III achalasia in 75 patients: a multicenter comparative study. Endosc International Open 2015;03:E195-201.CrossRef
41.
go back to reference Onimaru M, Inoue H, Ikeda H, Yoshida A, Santi EG, Sato H, et al. Peroral endoscopic myotomy is a viable option for failed surgical esophagocardiomyotomy instead of redo surgical Heller myotomy: a single center prospective study. J Am Coll Surg. 2013;217(4):598-605.CrossRefPubMed Onimaru M, Inoue H, Ikeda H, Yoshida A, Santi EG, Sato H, et al. Peroral endoscopic myotomy is a viable option for failed surgical esophagocardiomyotomy instead of redo surgical Heller myotomy: a single center prospective study. J Am Coll Surg. 2013;217(4):598-605.CrossRefPubMed
42.
43.
go back to reference Swanstrom LL, Kurian A, Dunst CM, Sharata A, Bhayani N, Rieder E. Long-term outcomes of an endoscopic myotomy for achalasia: the POEM procedure. Ann Surg. 2012;256(4):659-67.CrossRefPubMed Swanstrom LL, Kurian A, Dunst CM, Sharata A, Bhayani N, Rieder E. Long-term outcomes of an endoscopic myotomy for achalasia: the POEM procedure. Ann Surg. 2012;256(4):659-67.CrossRefPubMed
44.
go back to reference Eckardt AJ, Eckardt VF. Treatment and surveillance strategies in achalasia: an update. Nat Rev Gastroenterol Hepatol. 2011;8(6):311-9.CrossRefPubMed Eckardt AJ, Eckardt VF. Treatment and surveillance strategies in achalasia: an update. Nat Rev Gastroenterol Hepatol. 2011;8(6):311-9.CrossRefPubMed
45.
go back to reference Von Renteln D, Fuchs KH, Fockens P, Bauerfeind P, Vassiliou MC, Werner YB, et al. Peroral endoscopic myotomy for the treatment of achalasia: an international prospective multicenter study. Gastroenterology. 2013;145(2):309-11 e1-3.CrossRef Von Renteln D, Fuchs KH, Fockens P, Bauerfeind P, Vassiliou MC, Werner YB, et al. Peroral endoscopic myotomy for the treatment of achalasia: an international prospective multicenter study. Gastroenterology. 2013;145(2):309-11 e1-3.CrossRef
46.
go back to reference Familiari P, Gigante G, Marchese M, Boskoski I, Tringali A, Perri V, et al. Peroral Endoscopic Myotomy for Esophageal Achalasia: Outcomes of the First 100 Patients With Short-term Follow-up. Ann Surg. 2016;263(1):82-7.CrossRefPubMed Familiari P, Gigante G, Marchese M, Boskoski I, Tringali A, Perri V, et al. Peroral Endoscopic Myotomy for Esophageal Achalasia: Outcomes of the First 100 Patients With Short-term Follow-up. Ann Surg. 2016;263(1):82-7.CrossRefPubMed
47.
go back to reference Werner YB, Costamagna G, Swanstrom LL, von Renteln D, Familiari P, Sharata AM, et al. Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years. Gut. 2016;65(6):899-906.CrossRefPubMed Werner YB, Costamagna G, Swanstrom LL, von Renteln D, Familiari P, Sharata AM, et al. Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years. Gut. 2016;65(6):899-906.CrossRefPubMed
Metadata
Title
POEM vs Laparoscopic Heller Myotomy and Fundoplication: Which Is Now the Gold Standard for Treatment of Achalasia?
Authors
Marco G. Patti
Ciro Andolfi
Steven P. Bowers
Nathaniel J. Soper
Publication date
01-02-2017
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 2/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-016-3310-0

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