Medium and long-term outcomes after pneumatic dilation or laparoscopic Heller myotomy for achalasia: a meta-analysis Journal Article


Authors: Weber, C. E.; Davis, C. S.; Kramer, H. J.; Gibbs, J. T.; Robles, L.; Fisichella, P. M.
Article Title: Medium and long-term outcomes after pneumatic dilation or laparoscopic Heller myotomy for achalasia: a meta-analysis
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%; P0.05). We conclude that despite a higher frequency of perforation, LHM affords greater long-term durability.
Journal Title: Surgical laparoscopy, endoscopy percutaneous techniques
Volume: 22
Issue: 4
ISSN: 1534-4908; 1530-4515
Publisher: Unknown  
Journal Place: United States
Date Published: 2012
Start Page: 289
End Page: 296
Language: English
DOI/URL:
Notes: ID: 12651; Status: MEDLINE; [Review]; Publishing Model: Journal available in: Print Citation processed from: Internet; NLM Journal Code: 100888751, dd2