Esophageal achalasia is a rare disorder characterized by a failure of the lower esophageal sphincter to relax during swallowing, combined with aperistalsis of the esophageal body. Treatment is not curative, but aims to eliminate the outflow resistance caused by the nonrelaxing lower esophageal sphincter. Current evidence suggests that both laparoscopic Heller myotomy and per oral endoscopic myotomy (POEM) are very effectiveinthe reliefof symptoms in patients with achalasia. Specifically, for type III achalasia, POEM may achieve higher success rates. However, POEM is associated to a very high incidence of pathologic reflux, with the risk of exchanging one disease–achalasia–with another–gastroesophageal reflux.
MoonenA., AnneseV., BelmansA.Long-term results of the European achalasia trial: a multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy.Gut2016; 65: 732–9.
3.
PerssonJ., JohnssonE., KosticS.Treatment of achalasia with laparoscopic myotomy or pneumatic dilatation: long-term results of a prospective, randomized study.World J Surg2015; 39: 713–20.
4.
HuelsenA., OumerR., AshcroftA.Achalasia: a 13-year, single-centre experience comparing endoscopic balloon dilatation and laparoscopic Heller myotomy.N Z Med J2016; 129: 41–50.
5.
RebecchiF., GiacconeC., FarinellaE.Randomized controlled trial of laparoscopic Heller myotomy plus Dor fundoplication versus Nissen fundoplication for achalasia: long-term results.Ann Surg2008; 248: 1023–30.
6.
SalvadorR., PesentiE., GobbiL.Postoperative gastroesophageal reflux after laparoscopic Heller-Dor for achalasia: true incidence with an objective evaluation.J Gastrointest Surg2017; 21: 17–22.
PattiM.G., FisichellaP.M.Laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia. How I do it.J Gastrointest Surg2008; 12: 764–6.
9.
ZaninottoG., CostantiniM., RizzettoC.Four hundred laparoscopic myotomies for esophageal achalasia: a single centre experience.Ann Surg2008; 248: 986–93.
10.
PerroneJ.M., FrisellaM.M., DesaiK.M.Results of laparoscopic Heller-Toupet operation for achalasia.Surg Endosc2004; 18: 1565–71.
11.
SchlottmannF., AndolfiC., KavittR.T.Multidisciplinary approach to esophageal achalasia: a single center experience.J Laparoendosc Adv Surg Tech A2017; 27: 358–62.
12.
SwanstromL.L., KurianA., DunstC.M.Long-term outcomes of an endoscopic myotomy for achalasia: the POEM procedure.Ann Surg2012; 256: 659–67.
13.
BhayaniN.H., KurianA.A., DunstC.M.A comparative study on comprehensive, objective outcomes of laparoscopic Heller myotomy with per-oral endoscopic myotomy (POEM) for achalasia.Ann Surg2014; 259: 1098–103.
14.
KhajancheeY.S., KannegantiS., LeatherwoodA.E.Laparoscopic Heller myotomy with Toupet fundoplication: outcomes predictors in 121 consecutive patients.Arch Surg2005; 140: 827–33.
15.
Von RentelnD., FuchsK.H., FockensP.Peroral endoscopic myotomy for the treatment of achalasia: an international prospective multicenter study.Gastroenterology2013; 145: 309–11.
16.
FamiliariP., GiganteG., MarcheseM.Peroral endoscopic myotomy for esophageal achalasia: outcomes of the first 100 patients with short-term follow-up.Ann Surg2016; 263: 82–7.
17.
WernerY.B., CostamagnaG., SwanströmL.L.Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years.Gut2016; 65: 899–906.
18.
PellegriniC., WetterL.A., PattiM.Thoracoscopic esophagomyotomy. Initial experience with a new approach for the treatment of achalasia.Ann Surg1992; 216: 291–6.
19.
PattiM.G., PellegriniC.A., HorganS.Minimally invasive surgery for achalasia: an 8-year experience with 168 patients.Ann Surg1999; 230: 587–93.
20.
RichardsW.O., TorquatiA., HolzmanM.D.Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial.Ann Surg2004; 240: 405–12.
21.
CamposG.M., VittinghoffE., RablC.Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis.Ann Surg2009; 249: 45–57.
22.
SharataA.M., DunstC.M., PescarusR.Peroral endoscopic myotomy (POEM) for esophageal primary motility disorders: analysis of 100 consecutive patients.J Gastrointest Surg2015; 19: 161–70.
23.
WorrellS.G., AlicubenE.T., BoysJ.Peroral endoscopic myotomy for achalasia in a thoracic surgical practice.Ann Thorac Surg2016; 101: 218–24.
24.
SchneiderA.M., LouieB.E., WarrenH.F.A matched comparison of per oral endoscopic myotomy to laparoscopic Heller myotomy in the treatment of achalasia.J Gastrointest Surg2016; 20: 1789–96.
25.
HungnessE.S., SternbachJ.M., TeitelbaumE.N.Per-oral endoscopic myotomy (POEM) after the learning curve: durable long-term results with a low complication rate.Ann Surg2016; 264: 508–17.
26.
SchlottmannF., LuckettD.J., FineJ.Laparoscopic Heller myotomy versus peroral endoscopic myotomy (POEM) for achalasia: a systematic review and meta-analysis.Ann Surg2018; 267: 451–60.
27.
PandolfinoJ.E., KwiatekM.A., NealisT.Achalasia: a new clinically relevant classification by high-resolution manometry.Gastroenterology2008; 135: 1526–33.
28.
SalvadorR., CostantiniM., ZaninottoG.The preoperative manometric pattern predicts the outcome of surgical treatment for esophageal achalasia.J Gastrointest Surg2010; 14: 1635–45.
29.
OuY.H., NieX.M., LiL.F.High-resolution manometric subtypes as a predictive factor for the treatment of achalasia: a meta-analysis and systematic review.J Dig Dis2016; 17: 222–35.
30.
KumbhariV., TieuA.H., OnimaruM.Peroral endoscopic myotomy (POEM) vs laparoscopic Heller myotomy (LHM) for the treatment of type III achalasia in 75 patients: a multicenter comparative study.Endosc Int Open2015; 3: E195–201.
31.
KhashabM.A., MessallamA.A., OnimaruM.International multicenter experience with peroral endoscopic myotomy for the treatment of spastic esophageal disorders refractory to medical therapy (with video).Gastrointest Endosc2015; 81: 1170–7.
32.
ZhangW., LinghuE.Q.Peroral endoscopic myotomy for type III achalasia of Chicago classification: outcomes with a minimum follow-up of 24 months.J Gastrointest Surg2017; 21: 785–91.
