Safety and efficacy of peroral endoscopic myotomy for treating achalasia in pediatric and geriatric patients: A meta-analysis.

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY

World Journal of Gastrointestinal Endoscopy Pub Date : 2024-10-16 DOI:10.4253/wjge.v16.i10.566

Xin-Xin Pu, Shu Huang, Chun-Yu Zhong, Xia Wang, Su-Fen Fu, Ying-Qin Lv, Kang Zou, Mu-Han Lü, Yan Peng, Xiao-Wei Tang

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引用次数: 0

Abstract

Background: As a less invasive technique, peroral endoscopic myotomy (POEM) has recently been widely accepted for treating achalasia with an excellent safety profile, durability, and efficacy in adults. In pediatric and geriatric patients, the treatment is more difficult.

Aim: To discuss the clinical outcomes of POEM in pediatric and geriatric patients with achalasia.

Methods: We conducted a comprehensive search of PubMed, Embase and Cochrane Library databases from inception to July 2024. The primary outcomes were technical and clinical success. Secondary outcomes of interest included adverse events and gastroesophageal reflux disease (GERD). The pooled event rates were calculated by comprehensive meta-analysis software.

Results: A total of 32 studies with 547 pediatric patients and 810 geriatric patients were included in this study. The pooled event rates of technical success, clinical success, GERD and adverse events of POEM for treating achalasia in pediatric patients were 97.1% [95% confidence interval (CI): 95.0%-98.3%; I² = 0%; P < 0.000], 93.2% (95%CI: 90.5%-95.2%; I² = 0%; P < 0.000), 22.3% (95%CI: 18.4%-26.7%; I² = 43.874%; P < 0.000) and 20.4% (95%CI: 16.6%-24.8%; I² = 67.217%; P < 0.000), respectively. Furthermore, in geriatric patients, the pooled event rates were 97.7% (95%CI: 95.8%-98.7%; I² = 15.200%; P < 0.000), 93.2% (95%CI: 90.3%-95.2%; I² = 0%; P < 0.000), 23.9% (95%CI: 19.4%-29.1%; I² = 75.697%; P < 0.000) and 10.8% (95%CI: 8.3%-14.0%; I² = 62.938%; P < 0.000], respectively.

Conclusion: Our findings demonstrated that POEM was an effective and safe technique for pediatric and geriatric patients with achalasia.

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口腔内窥镜肌切开术治疗小儿和老年贲门失弛缓症的安全性和有效性：荟萃分析

背景：作为一种创伤较小的技术，口腔内镜下肌切开术（POEM）近来已被广泛接受用于治疗成人贲门失弛缓症，具有极佳的安全性、持久性和疗效。目的：探讨口内镜下肌切开术（POEM）在儿童和老年贲门失弛缓症患者中的临床疗效：方法：我们对 PubMed、Embase 和 Cochrane Library 数据库进行了全面检索，检索时间从开始到 2024 年 7 月。主要结果是技术和临床成功率。次要结果包括不良事件和胃食管反流病（GERD）。汇总事件发生率由综合荟萃分析软件计算得出：本研究共纳入了 32 项研究，涉及 547 名儿科患者和 810 名老年患者。POEM治疗小儿贲门失弛缓症的技术成功率、临床成功率、胃食管反流率和不良事件的汇总事件率为97.1%[95%置信区间（CI）：95.0%-98.3%; I² = 0%; P < 0.000]、93.2% (95%CI: 90.5%-95.2%; I² = 0%; P < 0.000)、22.3% (95%CI: 18.4%-26.7%; I² = 43.874%; P < 0.000) 和 20.4% (95%CI: 16.6%-24.8%; I² = 67.217%; P < 0.000)。此外，在老年患者中，汇总事件发生率分别为 97.7% (95%CI: 95.8%-98.7%; I² = 15.200%; P < 0.000)、93.2% (95%CI: 90.3%-95.2%；I² = 0%；P < 0.000）、23.9%（95%CI：19.4%-29.1%；I² = 75.697%；P < 0.000）和10.8%（95%CI：8.3%-14.0%；I² = 62.938%；P < 0.000]：我们的研究结果表明，POEM 是一种对小儿和老年贲门失弛缓症患者有效且安全的技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Gastrointestinal Endoscopy GASTROENTEROLOGY & HEPATOLOGY-

自引率

5.00%

发文量

1164