Open vs. endoscopic cricopharyngeal myotomy; Is there a difference?

Area of Science:

• Otolaryngology
• Gastroenterology
• Surgical Innovation

Background:

• The upper esophageal sphincter (UES), primarily the cricopharyngeus muscle (CP), regulates esophageal entry.
• Dysfunction of the UES necessitates treatment, with myotomy being a definitive solution.
• Comparing open and endoscopic CP myotomy (CPM) is crucial for optimizing treatment strategies.

Purpose of the Study:

• To evaluate and compare the outcomes of open versus endoscopic CP myotomy.
• To determine the efficacy and safety of each surgical approach for UES dysfunction.

Main Methods:

• A retrospective review of patients undergoing open or endoscopic CPM between January 2010 and March 2015.
• Collection and direct comparison of demographic, clinical, operative, hospital, and postoperative data.
• Analysis of surgical time, symptomatic outcomes, UES pressure, hospital stay, complications, oral intake, and follow-up duration.

Main Results:

• The study included 38 open CPM and 41 endoscopic CPM patients, with differing gender distributions.
• Endoscopic CPM demonstrated statistically significant improvements in surgical time (p=0.008) and symptomatic outcomes (p=0.010).
• No significant differences were observed in preoperative UES pressure, hospital stay, complication rates, time to oral intake, or follow-up length.

Conclusions:

• Endoscopic CPM is a safe and effective alternative to the open surgical approach.
• Patients benefit from reduced operative times and enhanced symptomatic improvement with endoscopic CPM.
• This minimally invasive technique presents a favorable option for managing cricopharyngeal hyperfunction and UES dysfunction.