Efficacy of a novel small-caliber therapeutic endoscope in peroral endoscopic myotomy for esophageal motility disorders: a propensity score matching analysis.

IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Hirofumi Abe, Shinwa Tanaka, Hiroya Sakaguchi, Chise Ueda, Masato Kinoshita, Hitomi Hori, Tatsuya Nakai, Tetsuya Yoshizaki, Shinya Hoki, Hiroshi Tanabe, Satoshi Urakami, Takashi Toyonaga, Yuzo Kodama
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Abstract

Background: EG-840TP is a novel small-caliber therapeutic endoscope with a large working channel. We aimed to evaluate the treatment outcomes of peroral endoscopic myotomy using EG-840TP compared to those using a conventional therapeutic endoscope (GIF-H290T).

Methods: Patients who underwent peroral endoscopic myotomy for achalasia and non-achalasia esophageal motility disorders were enrolled between March 2021 and March 2023. Procedure times and other treatment outcomes were compared between patients treated with EG-840TP and GIF-H290T using propensity score matching analysis. In the subgroup analysis, patients were divided into subsets based on myotomy length, morphology, esophageal dilation, and operator skill, and the procedure time was compared between the matched groups.

Results: A total of 154 patients were enrolled in this study, and 39 patients treated using each type of scope were matched. The EG-840TP group tended to have a shorter procedure time than the GIF-H290T group. There were no significant differences between the groups in terms of short-term clinical success or perioperative adverse events. In the subgroup analysis, the procedure time of the EG-840TP group was significantly shorter than that of the GIF-H290T group when patients had a straight esophagus (44 min vs. 54 min, p = 0.0015) and the operator was a non-expert (49 min vs. 64 min, p = 0.031).

Conclusions: POEM using EG-840TP showed procedure time, clinical success, and adverse events equivalent to those of a conventional therapeutic endoscope. However, EG-840TP potentially contributed to a shorter procedure time in patients with a straight esophagus or in non-expert operators than GIF-H290T.

背景:EG-840TP是一种新型小口径治疗内窥镜,具有较大的工作通道。我们旨在评估使用 EG-840TP 和使用传统治疗内窥镜(GIF-H290T)进行口腔内镜下肌切开术的治疗效果:方法:2021 年 3 月至 2023 年 3 月期间,对因贲门失弛缓症和非贲门失弛缓症食管运动障碍而接受口腔内镜下肌切开术的患者进行了登记。通过倾向评分匹配分析,比较了接受 EG-840TP 和 GIF-H290T 治疗的患者的手术时间和其他治疗结果。在亚组分析中,根据肌切长度、形态、食管扩张程度和操作者技能将患者分为不同的亚组,并对匹配组之间的手术时间进行比较:结果:共有 154 名患者参与了这项研究,其中 39 名患者使用每种类型的手术镜进行了配对。EG-840TP 组的手术时间往往比 GIF-H290T 组短。在短期临床成功率和围手术期不良事件方面,两组之间没有明显差异。在亚组分析中,当患者食管平直(44 分钟 vs. 54 分钟,p = 0.0015)且操作者为非专业人员(49 分钟 vs. 64 分钟,p = 0.031)时,EG-840TP 组的手术时间明显短于 GIF-H290T 组:使用 EG-840TP 的 POEM 在手术时间、临床成功率和不良反应方面与传统治疗内窥镜相当。然而,与 GIF-H290T 相比,EG-840TP 有可能缩短直食道患者或非专业操作者的手术时间。
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来源期刊
Esophagus
Esophagus GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.90
自引率
8.30%
发文量
78
审稿时长
>12 weeks
期刊介绍: Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.
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