Safety and Efficacy of Peroral Endoscopic Shorter Myotomy versus Longer Myotomy for Patients with Achalasia: A Systematic Review and Meta-analysis

Zhang, Han; Zeng, Xinyi; Huang, Shu; Xia, Huifang; Shi, Lei; Jiang, Jiao; Ren, Wensen; Peng, Yan; Lü, Muhan; Tang, Xiaowei

doi:10.1155/2022/6770864

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…В ряде публикаций ПОЭМ стала «золотым» стандартом лечения пациентов с ахалазией пищевода из-за ее высокого профиля эффективности, безопасности, ближайших и отдаленных функциональных результатов [1,[10][11][12][13]. По нашим данным, техническая возможность вмешательства составила 99,09%, что совпадает с данными многих авторов [2,5,[8][9][10][11][12][13][14].…”

Section: Discussionunclassified

“…Ахалазия пищевода (АП) является одной из причин возникновения дисфагии. Считается, что основной причиной АП может быть избирательное нарушение нервно-мышечной передачи в межмышечном сплетении дистального отдела пищевода и нижнем пищеводном сфинктере [1][2][3].…”

Section: Introductionunclassified

“…Основной целью лечения является восстановление проходимости пищеводно-желудочного перехода. Ввиду неэффективности консервативного лечения в лечении пациентов с АП на первое место выходят эндоскопические методы: баллонная дилатация, введение ботулотоксина и т. д. При этом частота рецидивов АП может достигать более 18% через 2 года и 41% через 5 лет [2,[4][5][6][7].…”

Section: Introductionunclassified

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Nearest and ling-time outcomes of endoscopic treatment of patients with esophageal achalasia

Drobyazgin,

Chikinev,

Mit’Ko

2023

jour

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The purpose of the study is analyze of the results of peroral endoscopic myotomy in patients with esophageal achalasia. Material and methods. In the period 2017-2022 years peroral endoscopic myotomy in esophageal achalasia was performed in 110 patients (43 - men, 77 - women). Mean aged from 7 to 75 years. The duration of the disease ranged from 6 months to 40 years. Results. In 109 cases, the intervention was technically successful. The intervention was not successful due to the severity of fibrosis in the submucosal layer in 1 patient. The operation time ranged from 45 to 195 minutes. Complications during the intervention were in 9 (8,18%) patients. In the postoperative period, in 4 (3,63%) patients had complications that were eliminated by using flexible endoscopes. Patients were discharged from the hospital 3-5 days after the operation. There were not re-interventions performed. Erosive reflux esophagitis is the most common condition in the postoperative period. This condition was successfully stopped by inhibitors proton pump taking. When examining in the postoperative period and assessing the level quality of life using questionnaires SF-36, GIQLI and the Eckardt scale noted relief of dysphagia and a significant improvement in the main indicators. Conclusion. Peroral endoscopic myotomy in patients with esophageal achalasia can be the operation of choice in terms of efficiency, safety and long-term results, the level of quality of life in the postoperative period. To assess the long-term results of the intervention in this category of patients, further monitoring is required.

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Section: Discussionunclassified

Section: Introductionunclassified

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Nearest and ling-time outcomes of endoscopic treatment of patients with esophageal achalasia

Drobyazgin,

Chikinev,

Mit’Ko

2023

jour

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Peroral Endoscopic Myotomy: Short Versus Long Esophageal Myotomy for Achalasia Cardia: A Randomized Controlled Noninferiority Trial

Rai,

Kumar,

Goel

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background and Aims: The appropriate length of esophageal myotomy in peroral endoscopic myotomy (POEM) for achalasia cardia remains unclear. This study aimed to compare the outcome of short (≤3 cm) and long (≥6 cm) esophageal myotomy in patients with type I and II achalasia cardia. Methods: This single-blinded, randomized controlled noninferiority trial was conducted at a tertiary center between July 2021 and December 2021. Patients with achalasia types I and II were randomized into short (≤3 cm) and long (≥6 cm) esophageal myotomy groups. The primary outcome of the study was clinical success (Eckardt score ≤3) 1 year after the procedure. The secondary outcomes included a comparison of technical success, operating duration, occurrence of intraoperative adverse events, alterations in integrated relaxation pressure (IRP), change in barium column height after 5 minutes (1 mo), and gastroesophageal reflux disease (3 mo) between the groups. Results: Fifty-four patients were randomized into the short (n=27) or long (n=27) esophageal myotomy groups. Technical success rates were 100% (27/27) and 96.3% (26/27) in short myotomy (SM) and long myotomy (LM) groups, respectively. The clinical success rates were 96.3% (26/27) and 96.2% (25/26) in the SM and LM groups, respectively (P=0.998). The mean (±SD) length of the esophageal myotomy was 2.75±0.36 cm in the SM and 6.69±1.35 cm in the LM groups (P<0.001). The mean (±SD) procedure time for the SM and LM groups was 61.22±8.44 and 82.42±14.70 minutes (P<0.001), respectively. The mean integrated relaxation pressure (IRP), Eckardt score, adverse events, reflux esophagitis, symptomatic gastroesophageal reflux disease, and esophageal acid exposure (>6%) did not differ significantly between the 2 groups following POEM treatment. Conclusions: Short myotomy is noninferior to long myotomy in terms of clinical success, gastroesophageal reflux disease, and intraoperative adverse events at the short-term follow-up (P>0.05). Short myotomy resulted in a reduced operative time (P<0.05).

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Peroral endoscopic myotomy for the treatment of achalasia: single-center experience from 100 operations

Drobyazgin¹,

Chikinev²,

Mitko³

2023

Dok. gastroenterol.

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Safety and Efficacy of Peroral Endoscopic Shorter Myotomy versus Longer Myotomy for Patients with Achalasia: A Systematic Review and Meta-analysis

Cited by 4 publications

References 36 publications

Nearest and ling-time outcomes of endoscopic treatment of patients with esophageal achalasia

Nearest and ling-time outcomes of endoscopic treatment of patients with esophageal achalasia

Peroral Endoscopic Myotomy: Short Versus Long Esophageal Myotomy for Achalasia Cardia: A Randomized Controlled Noninferiority Trial

Peroral endoscopic myotomy for the treatment of achalasia: single-center experience from 100 operations

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