Laparoscopic surgery for esophageal achalasia: Multiport vs single-incision approach

Shuichi Fukuda, Kiyokazu Nakajima, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Hiroshi Miyata, Shuji Takiguchi, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

INTRODUCTION: SILS can potentially improve aesthetic outcomes without adversely affecting treatment outcomes, but these outcomes are uncertain in laparoscopic Heller-Dor surgery. We determined if the degree of patient satisfaction with aesthetic outcomes progressed with the equivalent treatment outcomes after the introduction of a single-incision approach to laparoscopic Heller-Dor surgery.

METHODS: We retrospectively reviewed 20 consecutive esophageal achalasia patients (multiport approach, n = 10; single-incision approach, n = 10) and assessed the treatment outcomes and patient satisfaction with the aesthetic outcomes.

RESULTS: In the single-incision approach, thin supportive devices were routinely used to gain exposure to the esophageal hiatus. No statistically significant differences in the operating time (210.2 ± 28.8 vs 223.5 ± 46.3 min; P = 0.4503) or blood loss (14.0 ± 31.7 vs 16.0 ± 17.8 mL; P = 0.8637) were detected between the multiport and single-incision approaches. We experienced no intraoperative complications. Mild dysphagia, which resolved spontaneously, was noted postoperatively in one patient treated with the multiport approach. The reduction rate of the maximum lower esophageal sphincter pressure was 25.1 ± 34.4% for the multiport approach and 21.8 ± 19.2% for the single-incision approach (P = 0.8266). Patient satisfaction with aesthetic outcomes was greater for the single-incision approach than for the multiport approach.

CONCLUSION: When single-incision laparoscopic Heller-Dor surgery was performed adequately and combined with the use of thin supportive devices, patient satisfaction with the aesthetic outcomes was higher and treatment outcomes were equivalent to those of the multiport approach.

Original languageEnglish
Pages (from-to)14-20
Number of pages7
JournalAsian journal of endoscopic surgery
Volume9
Issue number1
DOIs
Publication statusPublished - Feb 1 2016
Externally publishedYes

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Esophageal Achalasia
Esthetics
Laparoscopy
Patient Satisfaction
Equipment and Supplies
Lower Esophageal Sphincter
Intraoperative Complications
Deglutition Disorders
Pressure

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Fukuda, S., Nakajima, K., Miyazaki, Y., Takahashi, T., Makino, T., Kurokawa, Y., ... Doki, Y. (2016). Laparoscopic surgery for esophageal achalasia: Multiport vs single-incision approach. Asian journal of endoscopic surgery, 9(1), 14-20. https://doi.org/10.1111/ases.12226

Laparoscopic surgery for esophageal achalasia : Multiport vs single-incision approach. / Fukuda, Shuichi; Nakajima, Kiyokazu; Miyazaki, Yasuhiro; Takahashi, Tsuyoshi; Makino, Tomoki; Kurokawa, Yukinori; Yamasaki, Makoto; Miyata, Hiroshi; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro.

In: Asian journal of endoscopic surgery, Vol. 9, No. 1, 01.02.2016, p. 14-20.

Research output: Contribution to journalArticle

Fukuda, S, Nakajima, K, Miyazaki, Y, Takahashi, T, Makino, T, Kurokawa, Y, Yamasaki, M, Miyata, H, Takiguchi, S, Mori, M & Doki, Y 2016, 'Laparoscopic surgery for esophageal achalasia: Multiport vs single-incision approach', Asian journal of endoscopic surgery, vol. 9, no. 1, pp. 14-20. https://doi.org/10.1111/ases.12226
Fukuda S, Nakajima K, Miyazaki Y, Takahashi T, Makino T, Kurokawa Y et al. Laparoscopic surgery for esophageal achalasia: Multiport vs single-incision approach. Asian journal of endoscopic surgery. 2016 Feb 1;9(1):14-20. https://doi.org/10.1111/ases.12226
Fukuda, Shuichi ; Nakajima, Kiyokazu ; Miyazaki, Yasuhiro ; Takahashi, Tsuyoshi ; Makino, Tomoki ; Kurokawa, Yukinori ; Yamasaki, Makoto ; Miyata, Hiroshi ; Takiguchi, Shuji ; Mori, Masaki ; Doki, Yuichiro. / Laparoscopic surgery for esophageal achalasia : Multiport vs single-incision approach. In: Asian journal of endoscopic surgery. 2016 ; Vol. 9, No. 1. pp. 14-20.
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AU - Takahashi, Tsuyoshi

AU - Makino, Tomoki

AU - Kurokawa, Yukinori

AU - Yamasaki, Makoto

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AU - Takiguchi, Shuji

AU - Mori, Masaki

AU - Doki, Yuichiro

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N2 - INTRODUCTION: SILS can potentially improve aesthetic outcomes without adversely affecting treatment outcomes, but these outcomes are uncertain in laparoscopic Heller-Dor surgery. We determined if the degree of patient satisfaction with aesthetic outcomes progressed with the equivalent treatment outcomes after the introduction of a single-incision approach to laparoscopic Heller-Dor surgery.METHODS: We retrospectively reviewed 20 consecutive esophageal achalasia patients (multiport approach, n = 10; single-incision approach, n = 10) and assessed the treatment outcomes and patient satisfaction with the aesthetic outcomes.RESULTS: In the single-incision approach, thin supportive devices were routinely used to gain exposure to the esophageal hiatus. No statistically significant differences in the operating time (210.2 ± 28.8 vs 223.5 ± 46.3 min; P = 0.4503) or blood loss (14.0 ± 31.7 vs 16.0 ± 17.8 mL; P = 0.8637) were detected between the multiport and single-incision approaches. We experienced no intraoperative complications. Mild dysphagia, which resolved spontaneously, was noted postoperatively in one patient treated with the multiport approach. The reduction rate of the maximum lower esophageal sphincter pressure was 25.1 ± 34.4% for the multiport approach and 21.8 ± 19.2% for the single-incision approach (P = 0.8266). Patient satisfaction with aesthetic outcomes was greater for the single-incision approach than for the multiport approach.CONCLUSION: When single-incision laparoscopic Heller-Dor surgery was performed adequately and combined with the use of thin supportive devices, patient satisfaction with the aesthetic outcomes was higher and treatment outcomes were equivalent to those of the multiport approach.

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