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

Felix Nickel, Philip C. Müller, Javier R. de la Garza, Christian Tapking, Laura Benner, Lars Fischer, Daniel C. Steinemann, Christian Rupp, Georg R. Linke, Beat P. Müller-Stich

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)e17714
JournalMedicine
Volume98
Issue number44
DOIs
StatePublished - Nov 1 2019

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Esophageal Achalasia
Dilatation
Patient Satisfaction
Quality of Life

ASJC Scopus subject areas

  • Medicine(all)

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Nickel, F., Müller, P. C., de la Garza, J. R., Tapking, C., Benner, L., Fischer, L., ... Müller-Stich, B. P. (2019). Heller myotomy versus endoscopic balloon dilatation for achalasia: A single center experience. Medicine, 98(44), e17714. https://doi.org/10.1097/MD.0000000000017714

Heller myotomy versus endoscopic balloon dilatation for achalasia : A single center experience. / Nickel, Felix; Müller, Philip C.; de la Garza, Javier R.; Tapking, Christian; Benner, Laura; Fischer, Lars; Steinemann, Daniel C.; Rupp, Christian; Linke, Georg R.; Müller-Stich, Beat P.

In: Medicine, Vol. 98, No. 44, 01.11.2019, p. e17714.

Research output: Contribution to journalArticle

Nickel, F, Müller, PC, de la Garza, JR, Tapking, C, Benner, L, Fischer, L, Steinemann, DC, Rupp, C, Linke, GR & Müller-Stich, BP 2019, 'Heller myotomy versus endoscopic balloon dilatation for achalasia: A single center experience', Medicine, vol. 98, no. 44, pp. e17714. https://doi.org/10.1097/MD.0000000000017714
Nickel F, Müller PC, de la Garza JR, Tapking C, Benner L, Fischer L et al. Heller myotomy versus endoscopic balloon dilatation for achalasia: A single center experience. Medicine. 2019 Nov 1;98(44):e17714. https://doi.org/10.1097/MD.0000000000017714
Nickel, Felix ; Müller, Philip C. ; de la Garza, Javier R. ; Tapking, Christian ; Benner, Laura ; Fischer, Lars ; Steinemann, Daniel C. ; Rupp, Christian ; Linke, Georg R. ; Müller-Stich, Beat P. / Heller myotomy versus endoscopic balloon dilatation for achalasia : A single center experience. In: Medicine. 2019 ; Vol. 98, No. 44. pp. e17714.
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abstract = "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.",
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