Tefas Cristian, Ababneh Rami, Tanţău Marcel
Chirurgia (Bucur). 2018 Mar-Apr;113(2):185-191. doi: 10.21614/chirurgia.113.2.185.
Achalasia is an esophageal motor disorder that has multiple endoscopic and surgical methods of treatment. However, there is no consensus on optimal therapy in patients suffering from this disorder. This review discusses two therapies with similar but technically different concepts, peroral endoscopic myotomy and Heller surgical myotomy. After a brief introduction to the basic problems of achalasia, technical considerations, intra and postprocedural complications are presented and the advantages and disadvantages of the two procedures are discussed, based on the relevant articles in the literature. Heller surgical myotomy and peroral endoscopic myotomy appear to be similar in performance with similar results in terms of gastroesophageal reflux rates. However, with experience being gained in the field of endoscopic myotomy, this procedure seems more advantageous, with similar success rates to those of the established surgical technique, but offering shorter operating times, shorter hospitalizations and, ultimately, lower costs.
贲门失弛缓症是一种食管运动障碍性疾病，有多种内镜和手术治疗方法。然而，对于患有这种疾病的患者的最佳治疗方法尚无共识。本综述讨论了两种概念相似但技术上不同的治疗方法，即经口内镜下肌切开术和海勒手术肌切开术。在简要介绍贲门失弛缓症的基本问题后，介绍了技术要点、术中及术后并发症，并根据文献中的相关文章讨论了这两种手术的优缺点。海勒手术肌切开术和经口内镜下肌切开术在操作表现上似乎相似，在胃食管反流率方面结果也相似。然而，随着内镜下肌切开术领域经验的积累，该手术似乎更具优势，成功率与既定的手术技术相似，但手术时间更短、住院时间更短，最终成本更低。
