Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

Medium and long-term outcomes after pneumatic dilation or laparoscopic Heller myotomy for achalasia: a meta-analysis. Surg Laparosc Endosc Percutan Tech 2012 Aug;22(4):289-96

Date

08/10/2012

Pubmed ID

22874676

DOI

10.1097/SLE.0b013e31825a2478

Scopus ID

2-s2.0-84865511710   41 Citations

Abstract

Recent randomized studies comparing outcomes after pneumatic dilation (PD) and laparoscopic Heller myotomy (LHM) for the treatment of achalasia are conflicting and limited to short-term follow-up. Our meta-analysis compared the long-term durability of these approaches, with the hypothesis that LHM offers superior long-term remission compared with PD. We identified 36 studies published between 2001 and 2011 with at least 5 years of follow-up. Those studies describing PD included 3211 patients (mean age, 49.8 y). For PD, the mean 5-year remission rate was 61.9% and the mean 10-year remission rate was 47.9%. Overall, 1526 patients (mean age, 46.3 y) were treated with LHM; 83% received a fundoplication. In contrast, the mean 5- and 10-year remission rates after LHM were 76.1% and 79.6%, respectively. Finally, the perforation rate for LHM was twice that of PD (4.8% vs. 2.4%; P<0.05). We conclude that despite a higher frequency of perforation, LHM affords greater long-term durability.

Author List

Weber CE, Davis CS, Kramer HJ, Gibbs JT, Robles L, Fisichella PM

Author

Christopher Stephen Davis MD, MPH Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Dilatation
Esophageal Achalasia
Esophageal Sphincter, Lower
Female
Humans
Laparoscopy
Male
Middle Aged
Pressure
Prospective Studies
Retrospective Studies
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a