title: Data analyses and perspectives on laparoscopic surgery for esophageal achalasia.
abstract: In general, the treatment methods for esophageal achalasia are largely classified into four groups, including drug therapy using nitrite or a calcium channel blocker, botulinum toxin injection, endoscopic therapy such as endoscopic balloon dilation, and surgery. Various studies have suggested that the most effective treatment of esophageal achalasia is surgical therapy. The basic concept of this surgical therapy has not changed since Heller proposed esophageal myotomy for the purpose of resolution of lower esophageal obstruction for the first time in 1913, but the most common approach has changed from open-chest surgery to laparoscopic surgery. Currently, the laparoscopic surgery has been the procedure of choice for the treatment of esophageal achalasia. During the process of the transition from open-chest surgery to laparotomy, to thoracoscopic surgery, and to laparoscopic surgery, the necessity of combining antireflux surgery has been recognized. There is some debate as to which type of antireflux surgery should be selected. The Toupet fundoplication may be the most effective in prevention of postoperative antireflux, but many medical institutions have selected the Dor fundoplication which covers the mucosal surface exposed by myotomy. Recently, a new endoscopic approach, peroral endoscopic myotomy (POEM), has received attention. Future studies should examine the long-term outcomes and whether POEM becomes the gold standard for the treatment of esophageal achalasia.
authors.affiliation: Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga, Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Tsuboi
authors.affiliation: Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga, Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Omura
authors.affiliation: Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga, Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Yano
authors.affiliation: Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga, Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Hoshino
authors.affiliation: Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga, Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: Se-Ryung
authors.initials: SR
authors.lastname: Yamamoto
authors.affiliation: Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga, Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Akimoto
authors.affiliation: Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga, Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Masuda
authors.affiliation: Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga, Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kashiwagi
authors.affiliation: Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga, Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D001905:Botulinum Toxins / Q000627:therapeutic use; D004931:Esophageal Achalasia / Q000601:surgery* / Q000628:therapy; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D004945:Esophagoscopy; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000517:prevention & control; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D013906:Thoracoscopy; D016896:Treatment Outcome
chemical_list: D001905:Botulinum Toxins
keywords: Esophageal achalasia; Laparoscopy; Review; Surgery; Treatment