Peroral Endoscopic Myotomy for Esophageal Achalasia:Analysis of 216 Cases
10.3969/j.issn.1008-7125.2014.09.004
- VernacularTitle:经口内镜下肌切开术治疗贲门失弛缓症216例分析
- Author:
Yuyong TAN
;
Deliang LIU
;
Jirong HUO
;
Xiaojuan LIU
;
Jie ZHANG
;
Zhiyuan ZHOU
- Publication Type:Journal Article
- Keywords:
Esophageal Achalasia;
Peroral Endoscopic Myotomy;
Treatment Outcome;
Safety;
Retrospective Studies
- From:Chinese Journal of Gastroenterology
2014;(9):527-530
- CountryChina
- Language:Chinese
-
Abstract:
Background:There have been several studies about peroral endoscopic myotomy( POEM)for treating esophageal achalasia( EA). Although the feasibility,safety and effectiveness of POEM have been demonstrated,comparative studies of full-thickness and circular muscle myotomy were rare. Aims:To evaluate the efficacy and safety of POEM for treating patients with EA. Methods:A total of 216 patients with EA admitted from Aug. 2011 to Nov. 2013 at the Second Xiangya Hospital of Central South University were treated with POEM,of whom 133 received full-thickness myotomy and 83 received circular muscle myotomy. Data about Eckardt ’s score, diameter of esophageal lumen, intra- and post-operative complications and recurrence before and/or during periodical follow-up were collected,and the efficacy of full-thickness and circular muscle myotomy was compared. Results:All the 216 patients successfully underwent POEM with an average operation time of 59. 1 minutes. Average length of tunnel and myotomy were 13. 3 cm and 10. 1 cm,respectively. Symptoms remitted in all of the 216 patients,Eckardt’s score decreased significantly,diameter of esophageal lumen was reduced(pre-treatment vs. 6 months after treatment,53. 7 mm vs. 30. 8 mm,P<0. 001),and complications occurred in 13. 0%(28/216)of the cases. Success treatment was achieved in 99. 1%(214/216)of the cases with a follow-up of 3-30 months( mean 13. 8 months),no recurrence was noted. The operation time,efficacy and complications were comparable between full-thickness and circular muscle myotomy(P>0. 05). Conclusions:POEM is an effective and safe method for treating EA. Full-thickness myotomy did not increase the operation time and procedure-related complications, however,its long-term efficacy and complications need to be further assessed.
