Heller myotomy versus endoscopic balloon dilatation for achalasia: A single center experience.


Journal

Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R

Informations de publication

Date de publication:
Nov 2019
Historique:
entrez: 7 11 2019
pubmed: 7 11 2019
medline: 15 11 2019
Statut: ppublish

Résumé

This study aimed to compare clinical results, symptom relief, quality of life and patient satisfaction after the 2 most common procedures for achalasia treatment: laparoscopic Heller myotomy (LHM) and endoscopic balloon dilatation (EBD).Patients treated at University Hospital of Heidelberg with LHM or EBD were included. A retrospective chart review of perioperative data and a prospective follow-up of therapeutic efficiency, Gastrointestinal Quality of Life Index (GIQLI) and patient satisfaction was conducted.Follow-up data (mean follow-up: 75.1 ± 53.9 months for LHM group and 78.9 ± 45.6 months for EBD) were obtained from 36 patients (19 LHM; 17 EBD). Eckardt score (median (q1,q3): 2 (1,4) in both groups, P = .91, GIQLI (LHM: 117 (91.5, 126) vs EBD: 120 (116, 128), P = .495) and patient satisfaction (3 (2,3) vs 3 (2,4), P = .883) did not differ between groups. Fifteen patients (78.9%) in LHM group and 11 (64.7%) in EBD group (P = .562) stated they would undergo the intervention again. All patients with EBD had at least 2 dilatations (100%), whilst only 2 patients (10.5%) had dilatation after LHM (P < .001). There were no complications after EBD, but 2 after LHM (10.5%, P = .517).Both LHM and EBD are able to control symptoms and provide similar quality of life and patient satisfaction. However, reintervention rate was higher following EBD, hence LHM provided a more sustained treatment than EBD.

Identifiants

pubmed: 31689807
doi: 10.1097/MD.0000000000017714
pii: 00005792-201911010-00067
pmc: PMC6946323
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e17714

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Auteurs

Felix Nickel (F)

Department of General, Visceral and Transplant Surgery.

Philip C Müller (PC)

Department of General, Visceral and Transplant Surgery.

Javier R de la Garza (JR)

Department of General, Visceral and Transplant Surgery.

Christian Tapking (C)

Department of General, Visceral and Transplant Surgery.

Laura Benner (L)

Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, Heidelberg.

Lars Fischer (L)

Department of Surgery, Hospital Mittelbaden, Balger Strasse 50, 76532 Baden-Baden, Germany.

Daniel C Steinemann (DC)

Department of Surgery, St. Claraspital AG, Kleinriehenstrasse 30, 4058 Basel, Switzerland.

Christian Rupp (C)

Department of Internal Medicine, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.

Georg R Linke (GR)

Department of Surgery, Hospital STS Thun AG, Krankenhausstrasse 12, 3600 Thun, Switzerland.

Beat P Müller-Stich (BP)

Department of General, Visceral and Transplant Surgery.

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