Efficacy and safety of laparoscopic Heller myotomy and peroral endoscopic myotomy in patients with achalasia of the cardia

Abstract

Objective To investigate the efficacy and safety of laparoscopic Heller myotomy and peroral endoscopic myotomy (POEM) in patients with achalasia of the cardia. Methods 109 cases of patients with achalasia of the cardia in our hospital from January 2015 to January 2017 were chosen as experimental subjects, and were divided into control group and research group with the random number table. The control group was treated with POEM, and the research group was treated with laparoscopic Heller myotomy. After the treatment, operation time, time of hospitalization, intraoperative bleeding, hospitalization expenses, Eckardt score, maximum width of the esophagus, recurrence, and complications were compared between the two groups. Results The operation time and time of hospitalization of the research group were shorter than those of the control group [(54.17±26.35)min vs.(125.63±31.76) min, (5.76±1.08)d vs.(7.64±1.47)d], intraoperative bleeding and hospitalization expenses were less than those of the control group [(11.28±3.12)ml vs.(73.61±38.29)ml, (1.68±0.71) ten thousand yuan vs.(2.19±0.54) ten thousand yuan], with statistically significant differences (P 0.05). After the treatment, the Eckardt score and the maximum width of the esophagus were decreased in both two groups, with statistically significant differences compared with those before the treatment (P 0.05). During the follow-up, there were 3 cases (5.56%) of recurrence in the research group, and no recurrence in the control group, without statistically significant difference in the recurrence rate (χ2=1.334, P>0.05). Conclusion Laparoscopic Heller myotomy and peroral esophageal myotomy both can effectively improve the clinical symptoms of patients with achalasia of the cardia, peroral esophageal myotomy has some advantages in economic benefits and reduction of trauma. Key words: Achalasia of the cardia; Laparoscopic Heller myotomy; Peroral esophageal myotomy