Thursday, March 25, 2021

Laparoscopic versus robotic‐assisted Heller myotomy for the treatment of achalasia: a systematic review with meta‐analysis

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Abstract

Background

Robotic‐assisted laparoscopic Heller myotomy has been proposed as an alternative minimally invasive approach to traditional laparoscopy for the treatment of achalasia. This systematic review aims to compare the safety and postoperative outcomes of the two procedures.

Methods

Systematic literature search was performed in MEDLINE through Ovid, Scopus, and Cochrane to identify clinical trials and retrospective analyses. Outcome measures used for meta‐analysis included operative time, estimated blood loss, length of stay, 30‐day readmission, intraoperative esophageal perforation, conversion, mortality, morbidity, symptom relief beyond one year, reintervention for recurrent symptoms, and gastroesophageal reflux during follow‐up rates.

Results

7 studies were selected with a total of 3214 patients. The only factor to be statistically different is intraoperative esophageal perforation rate, which is lower in robotic‐assisted Heller myotomy compared to laparoscopic (OR = 0.1139; 95% CI, [0.0334, 0.3887]; P = 0.0005).

Conclusions

The results suggest a robotic approach is associated with improved patient safety.

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