Modified Peroral Endoscopic Myotomy Technique for Type II Achalasia: A Multicenter Retrospective Study

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research and Practice Pub Date : 2022-03-25 DOI:10.1155/2022/3424470

Huahui Zhang, Kuangjing Wang, Ying Fang, Z. Xiong, Min Lin, L. Jiang, Qiu-zhong Niu, Jin Huang

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引用次数: 2

Abstract

Aim This retrospective study is aimed at evaluating the outcomes of a modified peroral endoscopic myotomy (POEM) technique in patients with type II achalasia. Methods We performed a modified POEM procedure, which involved a shorter (total myotomy length = 4 cm), full-thickness myotomy, on 31 patients with type II achalasia. Clinical success rates, technical success rates, pre- and postoperative esophageal manometry results, complications, and reflux-related adverse events were evaluated. Results The clinical success (Eckardt score ≤ 3) rates were 100% and 88.9% within 2 years and beyond 2 years postoperatively, respectively. The median lower esophageal sphincter pressures (LESP) decreased from 31.6 (26.7-49.7) mmHg preoperatively to 13.4 (10.5-21.6) and 11.8 (7.4-16.7) mmHg (P < 0.001) at 6 and 12 months postoperatively, respectively. The median integrated relaxation pressure (IRP) decreased from 27.8 (20.6-37.5) mmHg preoperatively to 12.9 (11.3-23.4) and 11.6 (9.6-16.8) mmHg (P < 0.001) at 6 and 12 months after POEM, respectively. Only one case (3.2%) of mucosal injury, four (12.9%) cases of reflux esophagitis, and two (6.5%) cases of gastroesophageal reflux symptoms were reported. Conclusions The modified POEM technique showed excellent outcomes in patients with type II achalasia.

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改良经口内镜肌切开术治疗Ⅱ型贲门失弛缓症的多中心回顾性研究

目的本回顾性研究旨在评估改良经口内镜肌切开术（POEM）在II型贲门失弛缓症患者中的疗效。方法我们进行了改良的POEM手术，包括更短的（总肌切开长度=4 cm），全层肌切开术，治疗31例II型贲门失弛缓症患者。评估了临床成功率、技术成功率、术前和术后食管测压结果、并发症和反流相关不良事件。结果临床成功（Eckardt 评分≤3）术后2年内和2年以上的发生率分别为100%和88.9%。术后6个月和12个月，中位食管下括约肌压力（LESP）分别从术前的31.6（26.7-49.7）mmHg降至13.4（10.5-21.6）和11.8（7.4-16.7）mmHg（P<0.001）。POEM后6个月和12个月，中位综合舒张压（IRP）分别从术前的27.8（20.6-37.5）mmHg降至12.9（11.3-23.4）和11.6（9.6-16.8）mmHg（P<0.001）。仅报告了1例（3.2%）粘膜损伤、4例（12.9%）反流性食管炎和2例（6.5%）胃食管反流症状。结论改良POEM技术治疗II型贲门失弛缓症疗效良好。

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

Gastroenterology Research and Practice GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.40

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： Gastroenterology Research and Practice is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on all areas of gastroenterology, hepatology, pancreas and biliary, and related cancers. The journal welcomes submissions on the physiology, pathophysiology, etiology, diagnosis and therapy of gastrointestinal diseases. The aim of the journal is to provide cutting edge research related to the field of gastroenterology, as well as digestive diseases and disorders. Topics of interest include: Management of pancreatic diseases Third space endoscopy Endoscopic resection Therapeutic endoscopy Therapeutic endosonography.