Advertisement

World Journal of Surgery

, Volume 35, Issue 7, pp 1442–1446 | Cite as

Evolution of the Minimally Invasive Treatment of Esophageal Achalasia

  • Brian Bello
  • Fernando A. Herbella
  • Marco G. Patti
Article

Abstract

Thanks to the advent of laparoscopic techniques, the last decade and a half have witnessed a radical change in the treatment of esophageal achalasia. Because of the high success rate of the laparoscopic Heller myotomy, surgery has now become in many centers the first modality of treatment for achalasia. This shift in the treatment algorithm reflects the fact that laparoscopic Heller myotomy with partial fundoplication outperforms nonsurgical approaches, such as balloon dilatation and intrasphincteric botulinum toxin injection.

Keywords

Achalasia Lower Esophageal Sphincter Heller Myotomy Laparoscopic Heller Myotomy Robotic Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Ellis FH Jr, Crozier RE, Gibb SP (1986) Reoperative achalasia surgery. J Thorac Cardiovasc Surg 92:859–865PubMedGoogle Scholar
  2. 2.
    Ellis FH Jr (1993) Oesophagomyotomy for achalasia: a 22-year experience. Br J Surg 80:882–885PubMedCrossRefGoogle Scholar
  3. 3.
    Malthaner RA, Todd TR, Miller L et al (1994) Long-term results in surgically managed esophageal achalasia. Ann Thorac Surg 58:1343–1347PubMedCrossRefGoogle Scholar
  4. 4.
    Devaney EJ, Iannettoni MD, Orringer MB et al (2001) Esophagectomy for achalasia: patient selection and clinical experience. Ann Thorac Surg 72:854–858PubMedCrossRefGoogle Scholar
  5. 5.
    Sauer L, Pellegrini CA, Way LW (1989) The treatment of achalasia: a current perspective. Arch Surg 124:929–932PubMedGoogle Scholar
  6. 6.
    Streitz JM, Ellis FH Jr, Williamson WA et al (1996) Objective assessment of gastroesophageal reflux after short esophagomyotomy for achalasia with the use of manometry and pH monitoring. J Thorac Cardiovasc Surg 111:107–113PubMedCrossRefGoogle Scholar
  7. 7.
    Bonavina L, Nosadini A, Bardini R et al (1992) Primary treatment of esophageal achalasia: long-term results of myotomy and Dor fundoplication. Arch Surg 127:222–226PubMedGoogle Scholar
  8. 8.
    Pellegrini CA, Wetter LA, Patti MG et al (1992) Thoracoscopic esophagomyotomy: initial experience with a new approach for the treatment of achalasia. Ann Surg 216:291–296PubMedCrossRefGoogle Scholar
  9. 9.
    Shimi S, Nathason LK, Cuschieri A (1991) Laparoscopic cardiomyotomy for achalsia. J R Coll Surg Edinb 36:152–154PubMedGoogle Scholar
  10. 10.
    Patti MG, Arcerito M, De Pinto M et al (1998) Comparison of thoracoscopic and laparoscopic Heller myotomy for achalasia. J Gastrointest Surg 2:561–566PubMedCrossRefGoogle Scholar
  11. 11.
    Lindenmann J, Maier A, Eherer A et al (2005) The incidence of gastroesophageal reflux after transthoracic esophagocardiomyotomy without fundoplication: a long term follow-up. Eur J Cardiothorac Surg 27:357–360PubMedCrossRefGoogle Scholar
  12. 12.
    Stewart KC, Finley RJ, Clifton JC et al (1999) Thoracoscopic versus laparoscopic modified Heller myotomy for achalasia: efficacy and safety in 87 patients. J Am Coll Surg 189:164–170PubMedCrossRefGoogle Scholar
  13. 13.
    Kjellin AP, Granqvist S, Ramel S et al (1999) Laparoscopic myotomy without fundoplication in patients with achalasia. Eur J Surg 165:1162–1166PubMedCrossRefGoogle Scholar
  14. 14.
    Burpee SE, Mamazza J, Schlachta CM et al (2005) Objective analysis of gastroesophageal reflux after laparoscopic Heller myotomy: an anti-reflux procedure is required. Surg Endosc 19:9–14PubMedCrossRefGoogle Scholar
  15. 15.
    Falkenback D, Johansson J, Oberg S et al (2003) Heller’s esophagomyotomy with or without a 360 degrees floppy Nissen fundoplication for achalasia: long-term results from a prospective randomized study. Dis Esophagus 16:284–290PubMedCrossRefGoogle Scholar
  16. 16.
    Richards WO, Torquati A, Holzman MD et al (2004) Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial. Ann Surg 240:405–412PubMedCrossRefGoogle Scholar
  17. 17.
    Patti MG, Robinson T, Galvani C et al (2004) Total fundoplication is superior to partial fundoplication even when esophageal peristalsis is weak. J Am Coll Surg 198:863–869PubMedCrossRefGoogle Scholar
  18. 18.
    Frantzides CT, Moore RE, Carlson MA et al (2004) Minimally invasive surgery for achalasia: a 10-year experience. J Gastrointest Surg 8:18–23PubMedCrossRefGoogle Scholar
  19. 19.
    Rossetti G, Brusciano L, Amato G et al (2005) A total fundoplication is not an obstacle to esophageal emptying after Heller myotomy for achalasia: results of a long-term follow up. Ann Surg 241:614–621PubMedCrossRefGoogle Scholar
  20. 20.
    Duranceau A, LaFontaine ER, Vallieres B (1982) Effects of total fundoplication on function of the esophagus after myotomy for achalasia. Am J Surg 143:22–28PubMedCrossRefGoogle Scholar
  21. 21.
    Topart P, Deschamps C, Taillefer R et al (1992) Long-term effect of total fundoplication on the myotomized esophagus. Ann Thorac Surg 54:1046–1051PubMedCrossRefGoogle Scholar
  22. 22.
    Rebecchi F, Giaccone C, Farinella E et al (2008) Randomized controlled trial of laparoscopic Heller myotomy plus Dor fundoplication versus Nissen fundoplication for achalasia. Ann Surg 248:1023–1030PubMedCrossRefGoogle Scholar
  23. 23.
    Hunter JG, Trus TL, Branum GD et al (1997) Laparoscopic Heller myotomy and fundoplication for achalasia. Ann Surg 225:655–664PubMedCrossRefGoogle Scholar
  24. 24.
    Vogt D, Curet M, Pitcher D et al (1997) Successful treatment of esophageal achalasia with laparoscopic Heller myotomy and Toupet fundoplication. Am J Surg 174:709–714PubMedCrossRefGoogle Scholar
  25. 25.
    Oelschlager BK, Chang L, Pellegrini CA (2003) Improved outcome after extended gastric myotomy for achalasia. Arch Surg 138:490–495PubMedCrossRefGoogle Scholar
  26. 26.
    Perrone JM, Frisella MM, Desai KM et al (2004) Results of laparoscopic Heller-Toupet for achalasia. Surg Endosc 18:1565–1571PubMedGoogle Scholar
  27. 27.
    Khajanchee YS, Kanneganti S, Leatherwood AE et al (2005) Laparoscopic Heller myotomy with Toupet fundoplication: outcomes predictors in 121 consecutive patients. Arch Surg 140:827–833PubMedCrossRefGoogle Scholar
  28. 28.
    Zaninotto G, Constantini M, Rizzetto C et al (2008) Four hundred laparoscopic myotomies for esophageal achalasia: a single center experience. Ann Surg 248:986–993PubMedCrossRefGoogle Scholar
  29. 29.
    Yamamura MS, Gilster JC, Myers BS et al (2000) Laparoscopic Heller myotomy and anterior fundoplication for achalasia results in a high degree of patient satisfaction. Arch Surg 135:902–906PubMedCrossRefGoogle Scholar
  30. 30.
    Finley RJ, Clifton JC, Stewart KC et al (2001) Laparoscopic Heller myotomy improves esophageal emptying and the symptoms of achalasia. Arch Surg 136:892–896PubMedCrossRefGoogle Scholar
  31. 31.
    Ackroyd R, Watson DI, Devitt PG et al (2001) Laparoscopic cardiomyotomy and anterior partial fundoplication for achalasia. Surg Endosc 15:683–686PubMedCrossRefGoogle Scholar
  32. 32.
    Chapman JR, Joehl RJ, Murayama KM et al (2004) Achalasia treatment: improved outcome of laparoscopic myotomy with operative manometry. Arch Surg 139:508–513PubMedCrossRefGoogle Scholar
  33. 33.
    Wright AS, Williams CW, Pellegrini CA et al (2007) Long-term outcomes confirm the superior efficacy of extended Heller myotomy with Toupet fundoplication for achalasia. Surg Endosc 21:713–718PubMedCrossRefGoogle Scholar
  34. 34.
    Patti MG, Molena D, Fisichella PM et al (2001) Laparoscopic Heller myotomy and Dor fundoplication for achalasia: analysis of successes and failures. Arch Surg 136:870–877PubMedCrossRefGoogle Scholar
  35. 35.
    Palazzo F, Fisichella PM, Patti MG (2008) Minimally invasive esophageal procedures. In: Souba WW, Fink MP, Jurkovich GJ (eds) ACS surgery: principles and practice. WebMD, New YorkGoogle Scholar
  36. 36.
    Rosemurgy AS, Morton CA, Rosas M et al (2010) A single institution’s experience with more than 500 laparoscopic Heller myotomies for achalasia. J Am Coll Surg 210:637–647PubMedCrossRefGoogle Scholar
  37. 37.
    Huffman LC, Pandalai PK, Boulton BJ et al (2007) Robotic Heller myotomy: a safe operation with higher postoperative quality-of-life indices. Surgery 142:613–620CrossRefGoogle Scholar
  38. 38.
    Horgan S, Galvani C, Gorodner MV et al (2005) Robotic-assisted heller myotomy versus laparoscopic Heller myotomy for the treatment of esophageal achalasia: multicenter study. J Gastrointest Surg 9:1020–1030PubMedCrossRefGoogle Scholar
  39. 39.
    Inoue H, Minami H, Kobayashi Y et al (2010) Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy 42:265–271PubMedCrossRefGoogle Scholar
  40. 40.
    Patti MG, Fisichella PM, Perretta S et al (2003) Impact of minimally invasive surgery on the treatment of esophageal achalasia: a decade of change. J Am Coll Surg 196:698–703PubMedCrossRefGoogle Scholar
  41. 41.
    Eckardt VF, Gockel I, Bernhard G (2004) Pneumatic dilation for achalasia: late results of a prospective follow up investigation. Gut 53:629–633PubMedCrossRefGoogle Scholar
  42. 42.
    Zaninotto G, Annese V, Costantini M et al (2004) Randomized controlled trial of botulinum toxin versus laparoscopic Heller myotomy for esophageal achalasia. Ann Surg 239:364–370PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Brian Bello
    • 1
  • Fernando A. Herbella
    • 1
  • Marco G. Patti
    • 1
  1. 1.Department of SurgeryUniversity of Chicago Pritzker School of MedicineChicagoUSA

Personalised recommendations