» Articles » PMID: 25212065

Laparoscopic Heller Myotomy for Achalasia: Does the Age of the Patient Affect the Outcome?

Overview
Journal World J Surg
Publisher Wiley
Specialty General Surgery
Date 2014 Sep 13
PMID 25212065
Authors
Affiliations
Soon will be listed here.
Abstract

Esophageal achalasia is the most common primary motility disorder of the esophageal body and lower esophageal sphincter. The optimal management strategy for elderly patients with achalasia remains inconclusive, however elderly patients are still more likely to be recommended for endoscopic treatments rather than LHM, due to a perception of increased surgical risk in these patients. Advantages of surgical myotomy in the elderly over pneumatic dilation are: 1. the risk of mucosal perforation during surgery is better controlled than after endoscopic balloon dilatation and 2. the greater efficacy for the surgical approach where only one procedure is routinely required whereas pneumatic dilation often requires repeat treatment to achieve long-term relief of symptoms.

References
1.
Birgisson S, Richter J . Achalasia in Iceland, 1952-2002: an epidemiologic study. Dig Dis Sci. 2007; 52(8):1855-60. DOI: 10.1007/s10620-006-9286-y. View

2.
Schoenberg M, Marx S, Kersten J, Rosch T, Belle S, Kahler G . Laparoscopic Heller myotomy versus endoscopic balloon dilatation for the treatment of achalasia: a network meta-analysis. Ann Surg. 2013; 258(6):943-52. DOI: 10.1097/SLA.0000000000000212. View

3.
Roll G, Ma S, Gasper W, Patti M, Way L, Carter J . Excellent outcomes of laparoscopic esophagomyotomy for achalasia in patients older than 60 years of age. Surg Endosc. 2010; 24(10):2562-6. PMC: 2945469. DOI: 10.1007/s00464-010-1003-4. View

4.
Inoue H, Tianle K, Ikeda H, Hosoya T, Onimaru M, Yoshida A . Peroral endoscopic myotomy for esophageal achalasia: technique, indication, and outcomes. Thorac Surg Clin. 2011; 21(4):519-25. DOI: 10.1016/j.thorsurg.2011.08.005. View

5.
Stefanidis D, Richardson W, Farrell T, Kohn G, Augenstein V, Fanelli R . SAGES guidelines for the surgical treatment of esophageal achalasia. Surg Endosc. 2011; 26(2):296-311. DOI: 10.1007/s00464-011-2017-2. View