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논문 기본 정보

자료유형
학술저널
저자정보
Tan Shali (Department of Gastroenterology Affiliated Hospital of Southwest Medical University Luzhou China) Zhong Chunyu (Department of Gastroenterology Affiliated Hospital of Southwest Medical University Luzhou China) Ren Yutang (Department of Gastroenterology Beijing Tsinghua Changgung Hospital Tsinghua University School of Cl) Luo Xujuan (Department of Gastroenterology Affiliated Hospital of Southwest Medical University Luzhou China) Xu Jin (Department of Gastroenterology Affiliated Hospital of Southwest Medical University Luzhou China) Fu Xiangsheng (Department of Gastroenterology Affiliated Hospital of North Sichuan Medical College Nanchong China) Peng Yan (Department of Gastroenterology Affiliated Hospital of Southwest Medical University Luzhou China) Tang Xiaowei (Department of Gastroenterology Affiliated Hospital of Southwest Medical University Luzhou China)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver 제15권 제2호
발행연도
2021.1
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153 - 167 (15page)

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Peroral endoscopic myotomy (POEM) has emerged as a rescue treatment for recurrent or persistent achalasia after failed initial management. Therefore, we aimed to investigate the efficacy and safety of POEM in achalasia patients with failed previous intervention. We searched the MEDLINE, Embase, Cochrane, and PubMed databases using the queries “achalasia,” “peroral endoscopic myotomy,” and related terms in March 2019. Data on technical and clinical success, adverse events, Eckardt score and lower esophageal sphincter (LES) pressure were collected. The pooled event rates, mean differences (MDs) and risk ratios (RR) were calculated. A total of 15 studies with 2,276 achalasia patients were included. Overall, the pooled technical success, clinical success and adverse events rate of rescue POEM were 98.0% (95% confidence interval [CI], 96.6% to 98.8%), 90.8% (95% CI, 88.8% to 92.4%) and 10.3% (95% CI, 6.6% to 15.8%), respectively. Seven studies compared the clinical outcomes of POEM between previous failed treatment and the treatment naive patients. The RR for technical success, clinical success, and adverse events were 1.00 (95% CI, 0.98 to 1.01), 0.98 (95% CI, 0.92 to 1.04), and 1.17 (95% CI, 0.78 to 1.76), respectively. Overall, there was significant reduction in the pre- and post-Eckardt score (MD, 5.77; p<0.001) and LES pressure (MD, 18.3 mm Hg; p<0.001) for achalasia patients with failed previous intervention after POEM. POEM appears to be a safe, effective and feasible treatment for individuals who have undergone previous failed intervention. It has similar outcomes in previously treated and treatment-naive achalasia patients.
#Esophageal achalasia #Meta-analysis #Pyloromyotomy #Safety #Treatment failure

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참고문헌 (34)

참고문헌 신청
Boeckxstaens GE / 2005 / The lower oesophageal sphincter / Neurogastroenterol Motil 17(Suppl 1):13~21 google schola Moonen A / 2016 / Long-term results of the European achalasia trial : a multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy / Gut 65:732~739 google schola Boeckxstaens GE / 2011 / Pneumatic dilation versus laparoscopic Heller’s myotomy for idiopathic achalasia / N Engl J Med 364:1807~1816 google schola Emami MH / 2008 / Pneumatic balloon dilation therapy is as effective as esophagomyotomy for achalasia / Dysphagia 23:155~160 google schola Kumbhari V / 2013 / Efficacy and safety of pneumatic dilatation for achalasia in the treatment of post-myotomy symptom relapse / Am J Gastroenterol 108:1076~1081 google schola

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