Peroral endoscopic myotomy in achalasia patients with long course of disease
10.3760/cma.j.cn321463-20230130-00521
- VernacularTitle:经口内镜下肌切开术治疗长病程贲门失弛缓症的临床研究
- Author:
Jianing SUN
1
;
Qingpeng XU
;
Yifan MA
;
Haoran LIU
;
Linning XU
;
Qinfei XUE
;
Hanchao PAN
;
Siyue ZHANG
;
Dongtao SHI
;
Rui LI
Author Information
1. 苏州大学附属第一医院消化内科，苏州 215006
- Keywords:
Cardia;
Peroral endoscopic myotomy;
Disease course;
Achalasia;
Therapy
- From:
Chinese Journal of Digestive Endoscopy
2023;40(8):630-634
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of peroral endoscopic myotomy (POEM) in achalasia of cardia (AC) patients with the long course.Methods:A total of 159 AC patients who received POEM from January 2015 to March 2022 in the First Affiliated Hospital of Soochow University were divided into the long course group (≥10 years) and the non-long course group (<10 years). The baseline information, POEM procedure and postoperative recurrence were compared and the differences between the recurrent patients and non-recurrent patients in the long course group were explored.Results:The age (57.09±14.30 years VS 42.08±15.68 years, t=5.569, P<0.001), the rate of treatment history [28.9% (13/45) VS 9.6% (11/114), χ2=9.319, P=0.020], the proportion of Henderson grade Ⅲ esophagus [17.8% (8/45) VS 6.1% (7/114), χ2=7.020, P=0.030] in the long course group were significantly higher than those in the non-long course group. The recurrence rate in the long course group was significantly higher than that in the non-long course group [33.3% (15/45) VS 14.9% (17/114), χ2=6.811, P=0.009]. In the long course group, the age (62.50 ± 16.94 years VS 53.77 ± 12.95 years, t=-2.121, P=0.040), and the rate of treatment history [53.3% (8/15) VS 16.7% (5/30), χ2=6.544, P=0.016] in the recurrent patients were higher than those in the non-recurrent patients. Conclusion:POEM is safe and effective for long-course AC patients. In patients with the long course, the aged patients with previous treatment are more likely to relapse.
