Robotic and per-oral endoscopic myotomy have fewer technical complications compared to laparoscopic Heller myotomy

摘要: Achalasia is an uncommon disease treated by decreasing the lower esophageal sphincter resting pressure. This study compared safety and efficacy of esophago-gastric myotomy via laparoscopic, robotic, per-oral endoscopic approaches. A retrospective review data on patients with achalasia or other dysmotility disorder undergoing robotically assisted, (POEM) procedures between 2013 2017 was performed. Patient demographics, comorbidities, procedure details, length stay, 30-day readmission rate, combined technical complication (full-thickness injury, conversion to open, delayed perforation) were compared. Multiple logistic regression analysis performed determine which factors contributed complication. There 171 who underwent 161 (94.2%) having achalasia. 40 laparoscopic Heller myotomies partial fundoplication, 44 robotic 87 POEM during period. Baseline statistical differences found among groups in regard gastroesophageal reflux symptoms, arrhythmia, hypertension, congestive heart failure. Laparoscopic had significantly higher complications (7, 17.5%) assisted (0, 0%) (1, 1.1%). Multivariate showed that (OR 32.22; 95% CI 2.66, 389.83; p = 0.01), myocardial infarction 27.94; 1.66, 471.10; p = 0.02), history smoking 8.87; 1.29, 61.15; p = 0.03) risks for developing complications. Robotically are safe efficacious treatments rates myotomy. With advancements instruments surgery, should be considered treatment disorders.