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Heller myotomy versus endoscopic balloon dilatation for achalasia: a single center experience

This study aimed to compare clinical results, symptom relief, quality of life and patient satisfaction after the 2 most common procedures for achalasia treatment: laparoscopic Heller myotomy (LHM) and endoscopic balloon dilatation (EBD). - Patients treated at University Hospital of Heidelber...

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Bibliographic Details
Main Authors: Nickel, Felix (Author) , Benner, Laura (Author) , Rupp, Christian (Author) , Müller, Philip C. (Author) , Müller, Beat P. (Author) , Linke, Georg R. (Author)
Format: Article (Journal)
Language:English
Published: November 2019
In: Medicine
Year: 2019, Volume: 98, Issue: 44
ISSN:1536-5964
DOI:10.1097/MD.0000000000017714
Online Access:Verlag, Volltext: https://doi.org/10.1097/MD.0000000000017714
Verlag, Volltext: https://journals.lww.com/md-journal/FullText/2019/11010/Heller_myotomy_versus_endoscopic_balloon.67.aspx
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Author Notes:Felix Nickel, MD, MME, Philip C. Müller, MD, Javier R. de la Garza, MD, Christian Tapking, MD, MMS, Laura Benner, MSc, Lars Fischer, MD, MBA, Daniel C. Steinemann, MD, Christian Rupp, MD, Georg R. Linke, MD, Beat P. Müller-Stich, MD
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Summary:This study aimed to compare clinical results, symptom relief, quality of life and patient satisfaction after the 2 most common procedures for achalasia treatment: laparoscopic Heller myotomy (LHM) and endoscopic balloon dilatation (EBD). - Patients treated at University Hospital of Heidelberg with LHM or EBD were included. A retrospective chart review of perioperative data and a prospective follow-up of therapeutic efficiency, Gastrointestinal Quality of Life Index (GIQLI) and patient satisfaction was conducted. - Follow-up data (mean follow-up: 75.1 ± 53.9 months for LHM group and 78.9 ± 45.6 months for EBD) were obtained from 36 patients (19 LHM; 17 EBD). Eckardt score (median (q1,q3): 2 (1,4) in both groups, P = .91, GIQLI (LHM: 117 (91.5, 126) vs EBD: 120 (116, 128), P = .495) and patient satisfaction (3 (2,3) vs 3 (2,4), P = .883) did not differ between groups. Fifteen patients (78.9%) in LHM group and 11 (64.7%) in EBD group (P = .562) stated they would undergo the intervention again. All patients with EBD had at least 2 dilatations (100%), whilst only 2 patients (10.5%) had dilatation after LHM (P < .001). There were no complications after EBD, but 2 after LHM (10.5%, P = .517). - Both LHM and EBD are able to control symptoms and provide similar quality of life and patient satisfaction. However, reintervention rate was higher following EBD, hence LHM provided a more sustained treatment than EBD.
Item Description:Gesehen am 06.02.2020
Physical Description:Online Resource
ISSN:1536-5964
DOI:10.1097/MD.0000000000017714

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