Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2023; 15(10): 593-601
Published online Oct 16, 2023. doi: 10.4253/wjge.v15.i10.593
Direct cost variance analysis of peroral endoscopic myotomy vs heller myotomy for management of achalasia: A tertiary referral center experience
Syedreza Ali Haider, Gregory S Bills, C Prakash Gyawali, Passisd Laoveeravat, Jordan Miller, Samir Softic, Mihir S Wagh, Moamen Gabr
Syedreza Ali Haider, Department of Internal Medicine, Washington University School of Medicine St. Louis, St. Louis, MO 63018, United States
Gregory S Bills, Passisd Laoveeravat, Department of Digestive Disease and Nutrition, University of Kentucky College of Medicine, Lexington, KY 40508, United States
C Prakash Gyawali, Department of Internal Medicine, Washington University School of Medicine St. Louis and Barnes Jewish Hospital, St. Louis, MO 63108, United States
Jordan Miller, Department of Cardiothoracic Surgery, University of Kentucky College of Medicine, Lexington, KY 40508, United States
Samir Softic, Department of Pediatrics, University of Kentucky College of Medicine and Kentucky Children’s Hospital, Lexington, KY 40508, United States
Mihir S Wagh, Interventional Endoscopy, Division of Gastroenterology, University of Colorado School of Medicine, Aurora, CO 80045, United States
Moamen Gabr, Department of Advanced Endoscopy, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States
Author contributions: Haider SA conducted primary data collection, performed data analysis, and took the lead in drafting the initial manuscript; Gyawali CP, Miller J, Softic S, and Wagh MS provided support in drafting the manuscript; Bills GS and Laoveeravat P participated in data collection, and also contributed to the study design; Gabr M played a role in shaping the overall study design, aiding in data collection, drafting the manuscript, and providing project leadership.
Institutional review board statement: The study protocol and data analysis described was approved by the University of Kentucky Institutional Review Board.
Informed consent statement: Given the retrospective nature of our study, informed consent was waived in concordance with University of Kentucky’s Institutional Review Board.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset related to the manuscript titled “Comparative Analysis of Laparoscopic Heller Myotomy and Per-oral Endoscopic Myotomy for Achalasia Treatment” are available from the corresponding author at rha275@uky.edu. Informed consent was waived by the Institutional Review Board, and the presented data have been anonymized to minimize the risk of identification. The potential benefits of sharing these data outweigh the potential harms as the data contribute to scientific understanding and informed decision-making in the field of gastroenterology.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Moamen Gabr, FASGE, MD, MSc, Director, Department of Advanced Endoscopy, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA 02215, United States. mgabr@bidmc.harvard.edu
Received: July 6, 2023
Peer-review started: July 6, 2023
First decision: August 4, 2023
Revised: August 23, 2023
Accepted: September 11, 2023
Article in press: September 11, 2023
Published online: October 16, 2023
Processing time: 96 Days and 0.1 Hours
Core Tip

Core Tip: This manuscript focuses on comparing the clinical outcomes and costs of laparoscopic Heller myotomy (LHM) and peroral endoscopic myotomy (POEM) as treatment options for achalasia, a rare esophageal motility disorder. Achalasia is characterized by impaired relaxation of the lower esophageal sphincter and abnormal peristalsis in the esophageal body, resulting in symptoms such as dysphagia, regurgitation, chest pain, and weight loss. The study aims to determine the clinical efficacy and cost-effectiveness of both procedures. By analyzing data from a tertiary-academic referral center, the researchers investigate the clinical outcomes, costs prior to and following the procedure, and adverse events associated with LHM and POEM.