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- Title
Surgical Treatment of Achalasia: Thoracoscopic or Laparoscopic?
- Authors
Bowrey, David J.; Blom, Dennis; Lord, Reginald V. N.
- Abstract
This study by Stewart <em>et al.</em> compared the thoracoscopic and laparoscopic methods of performing surgical myotomy for achalasia. Surgery was performed by one of two surgeons with the choice of approach left to the discretion of the operating surgeon. Twenty-four patients were treated by thoracoscopic myotomy and 63 by laparoscopic myotomy. Forty-five patients (52%) had undergone prior pneumatic dilation, and nine patients (10%) had received botulinum toxin injection. An antireflux procedure was performed in 55 of 63 (87%) patients undergoing laparoscopic myotomy, but in none of those undergoing thoracoscopic myotomy. Patients were followed up at 6 wk, at 3 monthly intervals for the first year thereafter and then annually. Both the operative time (median 3.0 <em>vs</em> 4.3 h,<em> p</em> = 0.01) and the hospital stay (median 4 <em>vs</em> 5 days, <em>p</em> = 0.03) were in favor of the laparoscopic approach. The postoperative complication rates were similar for the two groups. At a median follow-up time of 17 months, a clear advantage for laparoscopic myotomy was apparent, with relief of dysphagia occurring in 90% treated by this method, compared to 31% for those treated thoracoscopically, <em>p</em> < 0.01.
- Subjects
CHEST endoscopic surgery; LAPAROSCOPIC surgery; BOTULINUM toxin; DEGLUTITION disorders; SURGERY
- Publication
American Journal of Gastroenterology (Springer Nature), 2000, Vol 95, Issue 4, p1087
- ISSN
0002-9270
- Publication type
Article