Peroral endoscopic myotomy for achalasia
10.3760/cma.j.issn.1007-5232.2011.02.002
- VernacularTitle:经口内镜下肌切开术治疗贲门失弛缓症的初探
- Author:
Pinghong ZHOU
;
Liqing YAO
;
Mingyan CAI
;
Yunshi ZHONG
;
Zhong REN
;
Meidong XU
;
Weifeng CHEN
;
Wenzheng QIN
;
Jianwei HU
;
Liang LI
;
Jingzheng LIU
;
Ping WANG
;
Xinyu QIN
- Publication Type:Journal Article
- Keywords:
Deglutition disorders;
Esophageal achalasia;
Endoscopes;
Therapy
- From:
Chinese Journal of Digestive Endoscopy
2011;28(2):63-66
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and the feasibility of peroral endoscopic myotomy (POEM) for achalasia (AC). Methods The clinical data of 8 patients diagnosed as having AC and receiving POEM at our center from August 2010 to December 2010 were reviewed. The patients were 16-62 years old, mean 43yr, whose disease courses lasted for 2-20 years, mean 8.4 years. The key procedures of POEM were as the following, esophageal mucosal incision, submucosal tunneling by endoscopic submucosal dissection ( ESD), endoscopic myotomy of the circular muscle and closure of mucosal entry by hemostatic clips. Results All the 8 patients underwent POEM successfully. The mean operation time was 68.5 min ( ranging 45-115 min). The mean submucosal tunneling length was 9.5 cm ( ranging 8-13 cm). The average length of endoscopic myotomy of inner circular muscle was 8.5cm ( ranging 7-11 cm). No severe complications related to POEM occurred. Patients were followed up for 1-4 months ( mean 2. 5 months). Dysphagia was relieved significantly during the follow-up in 7 patients. But dysphagia and vomiting re-occurred in one patient 15 days after the operation. Endoscopy revealed a submucosal fistula, which was managed by incision. Conclusion As a new minimally invasive therapy for AC, POEM is very effective to relieve dysphagia in a short term. However, further observation is needed to evaluate long-term efficacy and complications.
