title: Peroral esophageal myotomy versus laparoscopic Heller's myotomy for achalasia: a meta-analysis.
abstract: BACKGROUND
  This meta-analysis aims to add convincing evidence on the application of peroral esophageal myotomy (POEM), compared with laparoscopic Heller's myotomy (LHM), for the treatment of achalasia.
  
  
  METHODS
  The electronic databases of PubMed, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Embase (up to December 2013) were systematically searched. EndNote(®) X6 citation software (Thomson Reuters, New York, NY) was used for literature management. A modification of the Newcastle-Ottawa Scale was applied for quality assessment. The data were analyzed using Review Manager version 5.1 software (The Cochrane Collaboration, Oxford, United Kingdom), and sensitivity analysis was performed by sequentially omitting each study.
  
  
  RESULTS
  Overall, four studies compared the outcomes between POEM and LHM. All studies were conducted in the United States and published in 2013. POEM was associated with comparable complications (odds ratio [OR]=1.17, 95% confidence interval [CI] 0.53-2.56, P=.70), gastroesophageal reflux (OR=1.00, 95% CI 0.38-2.61, P=1.00), and symptomatic recurrence by Eckardt score (OR=0.24, 95% CI 0.04-1.55, P=.13). Other outcomes including pain score, operating time, and hospital stay were assessed with no significant difference between POEM and LHM.
  
  
  CONCLUSIONS
  POEM achieves equivalent short-term outcomes compared with LHM for achalasia. This novel procedure is a promising treatment for achalasia.
authors: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, Sichuan Province, China .
authors: Mingtian
authors: M
authors: Wei
authors: Tinghan
authors: T
authors: Yang
authors: Xuyang
authors: X
authors: Yang
authors: Ziqiang
authors: Z
authors: Wang
authors: Zongguang
authors: Z
authors: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System / Q000379:methods*; D004931:Esophageal Achalasia / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D005764:Gastroesophageal Reflux; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult