Data analyses and perspectives on laparoscopic surgery for esophageal achalasia

Table 1 Comparison of surgical outcomes between laparoscopic Heller myotomy vs laparoscopic myotomy with fundoplication

Author	Year	Study design	Samples	Procedure	Follow up (mo)	Success	Postop-GERD
Campos et al[36]	2009	Meta-analysis	579	myotomy only	NA	90%	31%
			2507	myotomy + fundoplication	NA	90%	9%
Falkenback et al[37]	2003	RCT	10	myotomy only	96	70%	13%
			10	myotomy + fundoplication	96	70%	0.1%
Richards et al[10]	2004	RCT	21	myotomy only	6	100%	47.6%
			22	myotomy + fundoplication	6	95.5%	9.1%
Simić et al[38]	2010	RCT	22	myotomy only	36	100%	9.1%
			62	myotomy + fundoplication	36	91.7%	9.7%
Finley et al[39]	2007	Retrospective	24	myotomy only	12	100%	NA
			71	myotomy + fundoplication	12	98.6%	NA

NA: Not available; GERD: Gastroesophageal reflux disease; RCT: Retrospective cohort study.

Table 2 Comparison of surgical outcomes between laparoscopic Heller myotomy with Dor fundoplication vs laparoscopic myotomy with other fundoplication

Author	Year	Study design	Samples	Fundoplication	Follow up (mo)	Success	Postop-GERD
Rebecchi et al[40]	2008	RCT	71	Dor	125	97%	3%
			67	Nissen	125	85%	0%
Rawlings et al[41]	2012	RCT	36	Dor	6	91.7%	27.8%
			24	Toupet	6	95.8%	16.7%
Wright et al[42]	2007	Retrospective	52	Dor	46	82.7%	NA
			63	Toupet	45	95.2%	NA
Di Martino et al[43]	2011	Retrospective	30	Dor	24	93.4%	13.3%
			26	Nissen	24	92.3%	0%

NA: Not available; GERD: Gastroesophageal reflux disease; RCT: Retrospective cohort study.

Table 3 Comparison of surgical outcomes between laparoscopic Heller myotomy with fundoplication vs pneumatic dilation

Author	Year	Study design	Samples	Approach	Procedure	Follow up (mo)	Success	postop-GERD
Kostic et al[56]	2007	RCT	25	laparoscopy	myotomy + fundoplication	12	NA	NA
			26	endoscopy	pneumatic dilation	12	NA	NA
Novais et al[57]	2010	RCT	47	laparoscopy	myotomy + fundoplication	3	88.3%	4.7%
			47	endoscopy	pneumatic dilation	3	73.8%	31%
Boeckxstaens et al[58]	2011	RCT	106	laparoscopy	myotomy + fundoplication	43	90%	23%
			95	endoscopy	pneumatic dilation	43	86%	15%
Persson et al[59]	2014	RCT	25	laparoscopy	myotomy + fundoplication	60	92%	NA
			28	endoscopy	pneumatic dilation	60	64%	NA

NA: Not available; GERD: Gastroesophageal reflux disease; RCT: Retrospective cohort study.

Table 4 Comparison of surgical outcomes between laparoscopic Heller myotomy vs peroral endoscopic myotomy n (%)

Author	Year	Study design	Samples	Procedure	Follow up (d)	OP time (min)	Major complication (perforation)	Postop-GERD
Hungness et al[66]	2013	Retrospective	55	myotomy	42	125	1 (2)	NA
			18	POEM	42	113	1 (6)	7 (39)
Ujiki et al[67]	2013	Case control	21	myotomy	164	154.5	1 (4.8)	4 (19)
			18	POEM	116	155.8	1 (5.6)	5 (27.8)

Symptomatic GERD or PPI required. NA: Not available; GERD: Gastroesophageal reflux disease; POEM: Peroral endoscopic myotomy; OP: Operation.

Table 5 Surgical outcomes of reoperation for patients with achalasia

Author	Year	Samples	Approach (primary)	Approach (re-do)	Mucosal injury	Re-revision	Satisfaction
Iqbal et al[71]	2006	15	10: Laparoscopy	15: Laparoscopy	30%	20%	40%-89%
			3: Thoracoscopy	(2: Conversion to laparotomy)
			1: Laparotomy
			1: Thoracotomy
Rakita et al[73]	2007	12		11: Laparoscopy	NA	25%	82%
				1: Thoracoscopy
Grotenhuis et al[74]	2007	19	13: Abdominal	13: Abdominal	15.8%	10.5%	50%
			6: Thoracic	6: Thoracic
Loviscek et al[75]	2013	43	20: Abdominal	26: Laparoscopy	4.7%	9.3%	79%
			23: Thoracic
Omura et al[76]	2012	10	7: Laparoscopy	5: Laparoscopy	30%	NA	90%
			3: Thoracoscopy	2: Thoracoscopy
				1: Laparotomy
				1: Laparotomy + thoracotomy

NA: Not available.

Table 6 Surgical outcomes of reduced port surgery for patients with achalasia

Author	Year	Samples	Procedure	Follow up (mo)	OP time (min)	Mucosal injury	Conversion to laparotomy	Satisfaction
Barry et al[81]	2011	66	Myotomy + anterior fundoplication	NA	117	3%	0%	94%
Omura et al[82]	Epub	24	Myotomy + anterior fundoplication	8	230	13%	0%	90%

NA: Not available; OP: Operation.