Research progress of clinical application of laparoscopic Heller myotomy and peroral endoscopic myotomy in treatment of achalasia of cardia_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Siyu , LIU Jinlu ,  CHEN Junqiang

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P.R.China;

Corresponding?author：

CHEN Junqiang, Email: gxmufh@126.com

Keywords：

laparoscopic Heller myotomy; peroral endoscopic myotomy; achalasia of cardia; complications; efficacy

DOI：

10.7507/1007-9424.201702032

Video：

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Objective To compare effectiveness between laparoscopic Heller myotomy and peroral endoscopic myotomy (POEM) in treatment of achalasia of cardia (AC) in order to provide a basis for clinical choose. Method The literatures about the treatment of AC by laparoscopic Heller myotomy or POEM were retrieved from CNKI, Embase, PubMed databases, etc., and then the contents about curative effect and complications were summarized. Results The treatment models of AC included surgical treatment such as laparoscopic Heller myotomy and endoscopy such as POEM, but there was still lack of comparing data in these two treatment models, its selection remained controversial. There was a better short-term curative effect and slighter complications for POEM as compared with the laparoscopic Heller myotomy from the trend of published literatures. However, it’s long-term effects for these two treatment models were not clarified. Conclusions Both laparoscopic Heller myotomy and POEM are medicable for AC. POEM as a new treatment of AC shows some advantages of minimal invasion and exact efficacy, but it needs to be followed-up for a long-term. Treatment model for AC is chosen on basis of typing under endoscope, physical fitness, anatomy of easophagus, previous history, tolerance of surgery and other factors.

Citation： LIU Siyu, LIU Jinlu, CHEN Junqiang. Research progress of clinical application of laparoscopic Heller myotomy and peroral endoscopic myotomy in treatment of achalasia of cardia. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(8): 1025-1029. doi: 10.7507/1007-9424.201702032 Copy

1.	Minami H, Isomoto H, Yamaguchi N, et al. Peroral endoscopic myotomy for esophageal achalasia: clinical impact of 28 cases. Dig Endosc, 2014, 26(1): 43-51.
2.	劉麗梅, 閔敏, 徐楊. 賁門失弛緩癥的診治新進展. 中國繼續醫學教育, 2016, 8(5): 66-67.
3.	沃靜波, 許國強, 陳洪潭, 等. 經口內鏡下肌切開術治療 44 例賁門失弛緩癥的療效觀察. 中國內鏡雜志, 2016, 22(11): 1-5.
4.	包文晗, 段麗萍. 賁門失弛緩癥的治療進展. 中國微創外科雜志, 2016, 16(3): 281-285.
5.	令狐恩強, 李惠凱. 一種新的賁門失弛緩的內鏡下分型. 中華腔鏡外科雜志（電子版）, 2011, 4(5): 334-336.
6.	Pandolfino JE, Kwiatek MA, Nealis T, et al. Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology, 2008, 135(5): 1526-1533.
7.	Bredenoord AJ, R?sch T, Fockens P. Peroral endoscopic myotomy for achalasia. Neurogastroenterol Motil, 2014, 26(1): 3-12.
8.	令狐恩強, 李惠凱. 賁門失弛緩癥的內鏡下分型在隧道技術中的應用. 中國繼續醫學教育, 2011, 3(12): 78-80.
9.	談秋慧, 謝軍培, 韓曲, 等. 經口內鏡下肌切開術與腹腔鏡 Heller 手術治療賁門失弛緩癥的臨床療效對比. 胃腸病學和肝病學雜志, 2015, 24(9): 1104-1107.
10.	Kaman L, Iqbal J, Kochhar R2, et al. Laparoscopic Heller myotomy for achalasia cardia—initial experience in a teaching institute. Indian J Surg, 2013, 75(5): 391-394.
11.	Werner YB, Costamagna G, Swanstr?m LL, et al. Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years. Gut, 2016, 65(6): 899-906.
12.	于磊, 李建業, 王天佑, 等. 改良 Heller 手術治療賁門失弛緩癥的遠期療效. 中國胸心血管外科雜志, 2010, 8(4): 275-276.
13.	錢彬彬, 楊孫虎. 賁門失弛緩癥的微創治療進展. 腹腔鏡外科雜志, 2016, 21(10): 791-795.
14.	Ponsky JL, Marks JM, Pauli EM. How I do it: per-oral endoscopic myotomy (POEM). J Gastrointest Surg, 2012, 16(6): 1251-1255.
15.	Eleftheriadis N, Inoue H, Ikeda H, et al. Training in peroral endoscopic myotomy (POEM) for esophageal achalasia. Ther Clin Risk Manag, 2012, 8: 329-342.
16.	周平紅, 姚禮慶, 蔡明琰, 等. 經口內鏡下肌切開術治療賁門失弛緩癥的初探. 中華消化內鏡雜志, 2011, 28(2): 63-66.
17.	Minami H, Yamaguchi N, Matsushima K, et al. Improvement of endocytoscopic findings after per oral endoscopic myotomy (POEM) in esophageal achalasia; does POEM reduce the risk of developing esophageal carcinoma? Per oral endoscopic myotomy, endocytoscopy and carcinogenesis. BMC Gastroenterol, 2013, 13: 22.
18.	Stavropoulos SN, Modayil R, Friedel D. Per oral endoscopic myotomy for the treatment of achalasia. Curr Opin Gastroenterol, 2015, 31(5): 430-440.
19.	劉德良, 譚玉勇, 王學紅,等. 經口內鏡下肌切開術治療賁門失弛緩癥氣體相關并發癥的危險因素分析. 中華消化內鏡雜志, 2015, 32(1): 10-13.
20.	李冉, 張瑾, 徐蓮. 橫開口與縱開口內鏡下肌切開治療賁門失馳緩療效對比. 世界華人消化雜志, 2016, 24(26): 3804-3808.
21.	Shimi S, Nathanson LK, Cuschieri A. Laparoscopic cardiomyotomy for achalasia. J R Coll Surg Edinb, 1991, 36(3): 152-154.
22.	Schoenberg MB, Marx S, Kersten JF, et al. Laparoscopic Heller myotomy versus endoscopic balloon dilatation for the treatment of achalasia: a network meta-analysis. Ann Surg, 2013, 258(6): 943-952.
23.	Smith CD, Stival A, Howell DL, et al. Endoscopic therapy for achalasia before Heller myotomy results in worse outcomes than Heller myotomy alone. Ann Surg, 2006, 243(5): 579-586.
24.	魏寧, 胡文滕, 蔡謙謙, 等. 腹腔鏡 Heller 手術治療賁門失弛緩癥療效和安全性的Meta分析. 中國循證醫學雜志, 2016, 16(5): 573-578.
25.	Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy, 2010, 42(4): 265-271.
26.	馬曉冰, 令狐恩強, 李惠凱, 等. 經口內鏡下肌切開術治療賁門失弛緩癥安全性和有效性的影響因素. 南方醫科大學學報, 2016, 36(7): 892-897.
27.	Inoue H, Kudo SE. Per-oral endoscopic myotomy (POEM) for 43 consecutive cases of esophageal achalasia. Nihon Rinsho, 2010, 68(9): 1749-1752.
28.	趙威, 鄭忠青, 郭海英, 等. 經口內鏡下肌切開術與球囊擴張治療賁門失弛緩癥的對照研究. 中華消化雜志, 2016, 36(9): 577-581.
29.	Werner YB, Costamagna G, Swanstr?m LL, et al. Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years. Gut, 2016, 65(6): 899-906.
30.	Kumagai K, Tsai JA, Thorell A, et al. Per-oral endoscopic myotomy for achalasia. Are results comparable to laparoscopic Heller myotomy? Scand J Gastroenterol, 2015, 50(5): 505-512.
31.	晉弘, 張莉莉, 鄭忠青, 等. 經口內鏡下肌切開術治療賁門失弛緩癥術后 3 年療效評估. 中華消化雜志, 2015, 35(4): 217-220.
32.	和方偉, 于紅剛, 張軍, 等. 經口內鏡下全層肌切開術治療賁門失弛緩癥的短期療效分析. 中華消化內鏡雜志, 2016, 33(4): 211-214.
33.	Zaninotto G, Costantini M, Rizzetto C, et al. Four hundred laparoscopic myotomies for esophageal achalasia: a single centre experience. Ann Surg, 2008, 248(6): 986-993.
34.	Tsuboi K, Omura N, Yano F, et al. Data analyses and perspectives on laparoscopic surgery for esophageal achalasia. World J Gastroenterol, 2015, 21(38): 10830-10839.
35.	Pontone S, Urciuoli P, Pontone P, et al. Dor Against Toupet Fundoplication After Heller Myotomy. Laparoscopic Technical Improvements and Endoscopic Support. J Gastrointest Surg, 2011, 15(11):2119-2120.
36.	Zurita Macías Valadez LC, Pescarus R, Hsieh T, et al. Laparoscopic limited Heller myotomy without anti-reflux procedure does not induce significant long-term gastroesophageal reflux. Surg Endosc, 2015, 29(6): 1462-1468.
37.	Ren Z, Zhong Y, Zhou P, et al. Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases). Surg Endosc, 2012, 26(11): 3267-3272.
38.	Talukdar R, Inoue H, Nageshwar Reddy D. Efficacy of peroral endoscopic myotomy (POEM) in the treatment of achalasia: a systematic review and meta-analysis. Surg Endosc, 2015, 29(11): 3030-3046.
39.	Francis DL, Katzka DA.Achalasia: update on the disease and its treatment.Gastroenterology, 2010, 139(2): 369-374.
40.	李明陽, 劉寧, 陳倩倩, 等. 賁門失弛緩癥經口內鏡下肌切開術手術效果的影響因素分析. 中華胃腸內鏡電子雜志, 2016, 3(3): 99-102.
41.	李盈盈, 李惠凱, 翟亞奇, 等. 經口內鏡下肌切開術后賁門失弛緩癥患者食管下括約肌及食管體部動力變化的初步研究. 中華胃腸內鏡電子雜志, 2016, 3(1): 1-7.
42.	譚玉勇, 彭東子, 劉德良. 經口內鏡下肌切開術治療賁門失弛緩癥操作要點及其現狀(含視頻). 中華消化內鏡雜志, 2016, 33(7): 425-428.
43.	高楠, 史冬濤, 李銳, 等. 經口內鏡下肌切開術對賁門失弛緩癥患者生命質量影響的多中心研究. 中華消化雜志, 2015, 35(12): 822-824.

1. Minami H, Isomoto H, Yamaguchi N, et al. Peroral endoscopic myotomy for esophageal achalasia: clinical impact of 28 cases. Dig Endosc, 2014, 26(1): 43-51.
2. 劉麗梅, 閔敏, 徐楊. 賁門失弛緩癥的診治新進展. 中國繼續醫學教育, 2016, 8(5): 66-67.
3. 沃靜波, 許國強, 陳洪潭, 等. 經口內鏡下肌切開術治療 44 例賁門失弛緩癥的療效觀察. 中國內鏡雜志, 2016, 22(11): 1-5.
4. 包文晗, 段麗萍. 賁門失弛緩癥的治療進展. 中國微創外科雜志, 2016, 16(3): 281-285.
5. 令狐恩強, 李惠凱. 一種新的賁門失弛緩的內鏡下分型. 中華腔鏡外科雜志（電子版）, 2011, 4(5): 334-336.
6. Pandolfino JE, Kwiatek MA, Nealis T, et al. Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology, 2008, 135(5): 1526-1533.
7. Bredenoord AJ, R?sch T, Fockens P. Peroral endoscopic myotomy for achalasia. Neurogastroenterol Motil, 2014, 26(1): 3-12.
8. 令狐恩強, 李惠凱. 賁門失弛緩癥的內鏡下分型在隧道技術中的應用. 中國繼續醫學教育, 2011, 3(12): 78-80.
9. 談秋慧, 謝軍培, 韓曲, 等. 經口內鏡下肌切開術與腹腔鏡 Heller 手術治療賁門失弛緩癥的臨床療效對比. 胃腸病學和肝病學雜志, 2015, 24(9): 1104-1107.
10. Kaman L, Iqbal J, Kochhar R2, et al. Laparoscopic Heller myotomy for achalasia cardia—initial experience in a teaching institute. Indian J Surg, 2013, 75(5): 391-394.
11. Werner YB, Costamagna G, Swanstr?m LL, et al. Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years. Gut, 2016, 65(6): 899-906.
12. 于磊, 李建業, 王天佑, 等. 改良 Heller 手術治療賁門失弛緩癥的遠期療效. 中國胸心血管外科雜志, 2010, 8(4): 275-276.
13. 錢彬彬, 楊孫虎. 賁門失弛緩癥的微創治療進展. 腹腔鏡外科雜志, 2016, 21(10): 791-795.
14. Ponsky JL, Marks JM, Pauli EM. How I do it: per-oral endoscopic myotomy (POEM). J Gastrointest Surg, 2012, 16(6): 1251-1255.
15. Eleftheriadis N, Inoue H, Ikeda H, et al. Training in peroral endoscopic myotomy (POEM) for esophageal achalasia. Ther Clin Risk Manag, 2012, 8: 329-342.
16. 周平紅, 姚禮慶, 蔡明琰, 等. 經口內鏡下肌切開術治療賁門失弛緩癥的初探. 中華消化內鏡雜志, 2011, 28(2): 63-66.
17. Minami H, Yamaguchi N, Matsushima K, et al. Improvement of endocytoscopic findings after per oral endoscopic myotomy (POEM) in esophageal achalasia; does POEM reduce the risk of developing esophageal carcinoma? Per oral endoscopic myotomy, endocytoscopy and carcinogenesis. BMC Gastroenterol, 2013, 13: 22.
18. Stavropoulos SN, Modayil R, Friedel D. Per oral endoscopic myotomy for the treatment of achalasia. Curr Opin Gastroenterol, 2015, 31(5): 430-440.
19. 劉德良, 譚玉勇, 王學紅,等. 經口內鏡下肌切開術治療賁門失弛緩癥氣體相關并發癥的危險因素分析. 中華消化內鏡雜志, 2015, 32(1): 10-13.
20. 李冉, 張瑾, 徐蓮. 橫開口與縱開口內鏡下肌切開治療賁門失馳緩療效對比. 世界華人消化雜志, 2016, 24(26): 3804-3808.
21. Shimi S, Nathanson LK, Cuschieri A. Laparoscopic cardiomyotomy for achalasia. J R Coll Surg Edinb, 1991, 36(3): 152-154.
22. Schoenberg MB, Marx S, Kersten JF, et al. Laparoscopic Heller myotomy versus endoscopic balloon dilatation for the treatment of achalasia: a network meta-analysis. Ann Surg, 2013, 258(6): 943-952.
23. Smith CD, Stival A, Howell DL, et al. Endoscopic therapy for achalasia before Heller myotomy results in worse outcomes than Heller myotomy alone. Ann Surg, 2006, 243(5): 579-586.
24. 魏寧, 胡文滕, 蔡謙謙, 等. 腹腔鏡 Heller 手術治療賁門失弛緩癥療效和安全性的Meta分析. 中國循證醫學雜志, 2016, 16(5): 573-578.
25. Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy, 2010, 42(4): 265-271.
26. 馬曉冰, 令狐恩強, 李惠凱, 等. 經口內鏡下肌切開術治療賁門失弛緩癥安全性和有效性的影響因素. 南方醫科大學學報, 2016, 36(7): 892-897.
27. Inoue H, Kudo SE. Per-oral endoscopic myotomy (POEM) for 43 consecutive cases of esophageal achalasia. Nihon Rinsho, 2010, 68(9): 1749-1752.
28. 趙威, 鄭忠青, 郭海英, 等. 經口內鏡下肌切開術與球囊擴張治療賁門失弛緩癥的對照研究. 中華消化雜志, 2016, 36(9): 577-581.
29. Werner YB, Costamagna G, Swanstr?m LL, et al. Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years. Gut, 2016, 65(6): 899-906.
30. Kumagai K, Tsai JA, Thorell A, et al. Per-oral endoscopic myotomy for achalasia. Are results comparable to laparoscopic Heller myotomy? Scand J Gastroenterol, 2015, 50(5): 505-512.
31. 晉弘, 張莉莉, 鄭忠青, 等. 經口內鏡下肌切開術治療賁門失弛緩癥術后 3 年療效評估. 中華消化雜志, 2015, 35(4): 217-220.
32. 和方偉, 于紅剛, 張軍, 等. 經口內鏡下全層肌切開術治療賁門失弛緩癥的短期療效分析. 中華消化內鏡雜志, 2016, 33(4): 211-214.
33. Zaninotto G, Costantini M, Rizzetto C, et al. Four hundred laparoscopic myotomies for esophageal achalasia: a single centre experience. Ann Surg, 2008, 248(6): 986-993.
34. Tsuboi K, Omura N, Yano F, et al. Data analyses and perspectives on laparoscopic surgery for esophageal achalasia. World J Gastroenterol, 2015, 21(38): 10830-10839.
35. Pontone S, Urciuoli P, Pontone P, et al. Dor Against Toupet Fundoplication After Heller Myotomy. Laparoscopic Technical Improvements and Endoscopic Support. J Gastrointest Surg, 2011, 15(11):2119-2120.
36. Zurita Macías Valadez LC, Pescarus R, Hsieh T, et al. Laparoscopic limited Heller myotomy without anti-reflux procedure does not induce significant long-term gastroesophageal reflux. Surg Endosc, 2015, 29(6): 1462-1468.
37. Ren Z, Zhong Y, Zhou P, et al. Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases). Surg Endosc, 2012, 26(11): 3267-3272.
38. Talukdar R, Inoue H, Nageshwar Reddy D. Efficacy of peroral endoscopic myotomy (POEM) in the treatment of achalasia: a systematic review and meta-analysis. Surg Endosc, 2015, 29(11): 3030-3046.
39. Francis DL, Katzka DA.Achalasia: update on the disease and its treatment.Gastroenterology, 2010, 139(2): 369-374.
40. 李明陽, 劉寧, 陳倩倩, 等. 賁門失弛緩癥經口內鏡下肌切開術手術效果的影響因素分析. 中華胃腸內鏡電子雜志, 2016, 3(3): 99-102.
41. 李盈盈, 李惠凱, 翟亞奇, 等. 經口內鏡下肌切開術后賁門失弛緩癥患者食管下括約肌及食管體部動力變化的初步研究. 中華胃腸內鏡電子雜志, 2016, 3(1): 1-7.
42. 譚玉勇, 彭東子, 劉德良. 經口內鏡下肌切開術治療賁門失弛緩癥操作要點及其現狀(含視頻). 中華消化內鏡雜志, 2016, 33(7): 425-428.
43. 高楠, 史冬濤, 李銳, 等. 經口內鏡下肌切開術對賁門失弛緩癥患者生命質量影響的多中心研究. 中華消化雜志, 2015, 35(12): 822-824.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress of clinical application of laparoscopic Heller myotomy and peroral endoscopic myotomy in treatment of achalasia of cardia

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