title: Short-term surgical outcomes of reduced port surgery for esophageal achalasia.
abstract: OBJECTIVE
  To clarify the feasibility and utility of reduced port surgery (RPS) for achalasia.
  
  
  METHODS
  Between September 2005 and June 2013, 359 patients with esophageal achalasia, excluding cases of reoperation, underwent laparoscopic Heller myotomy and Dor fundoplication (LHD) according to our clinical pathway. Three-hundred and twenty-seven patients underwent LHD with five incisions (conventional approach), while the other 32 patients underwent RPS, including eight via SILS. The clinical data were collected in a prospective fashion and retrospectively reviewed. We selected 24 patients matched for gender, age and morphologic type with patients in the RPS group from among the 327 patients (C group). The surgical outcomes were compared between the C and RPS groups.
  
  
  RESULTS
  There were no significant differences between the two groups in the duration of symptoms, dysphagia score, chest pain score, shape of the distal esophagus and esophageal clearance. The operative time was significantly longer in the RPS group than in the C group (p < 0.001). There were no significant differences between the two groups in the length of postoperative hospital stay or rates of bleeding, mucosal injury of the esophagus and/or stomach and postoperative complications. The symptom scores significantly improved after surgery in both groups (p < 0.001). Furthermore, there were no significant differences between the C group and RPS group in terms of the postoperative symptom scores or satisfaction scores after surgery.
  
  
  CONCLUSIONS
  The surgical outcomes of RPS for achalasia are comparable to those obtained with the conventional method.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-Ku, Tokyo, 105-8461, Japan, surgomura@jikei.ac.jp.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Omura
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Yano
authors.forename: Kazuto
authors.initials: K
authors.lastname: Tsuboi
authors.forename: Masato
authors.initials: M
authors.lastname: Hoshino
authors.forename: Se Ryung
authors.initials: SR
authors.lastname: Yamamoto
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Akimoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kashiwagi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004931:Esophageal Achalasia / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome