ABSTRACT
OBJECTIVE@#To evaluate the efficacy and safety of peroral endoscopic myotomy (POEM) for achalasia cardia (AC). @*METHODS@#A total of 62 patients with AC were enrolled and treated with POEM in the Third Xiangya Hospital, Central South University from April 2012 to October 2014. The symptoms and complications were retrospectively analyzed. @*RESULTS@#The ages of patients, including 32 males and 30 females, were 14-68 (43.2±5.6) years old. Eckardt scores were 4-6 or ≥7 for 25 patients or 37 patients (including 20 patients were at a score of 12). Thirteen patients suffered balloon expansion for 2-3 times. Sixty-one patients had completed POEM treatment, 1 patient were given Heller surgery instead of POEM because of extensive submucosal adhesion during POEM. The operative time for POEM was (60.8±15.1) min. Fourteen patients had mild subcutaneous emphysema. Among them, 5 suffered pneumoperitoneum and felt better after abdominal puncture exhaust; 2 patients suffered bronchospasm hypoxemia and were relieved after treatment by positive pressure oxygen for 1 h. The hospital stay was (4.3±1.2) d. The postoperative follow-up period was (11.4±5.4) months. Swallowing obstruction, vomiting and chest pain in patients was relieved at different degrees. The treatment effective rate was 100%. @*CONCLUSION@#POEM is a safe, effective and minimally invasive approach for AC.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Cardia , Endoscopy , Methods , Esophageal Achalasia , General Surgery , Esophageal Sphincter, Lower , Length of Stay , Operative Time , Postoperative Period , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE@#To evaluate the curative effect and safety of endoscopic full-thickness resection (EFR) in the treatment of gastric tumor originated from the muscularis propria. @*METHODS@#Clinical data were collected from 34 patients, who underwent EFR of gastric tumor originated from muscularis propria, to observe the resection rate and complications from November 2012 to August 2014. @*RESULTS@#Of the 34 patients, 15 were male, 19 were female, with the age of 38.3-70.6 (52.3±4.3) years old. The lesions of 25 patients located in the fundus of stomach and the rest was in the gastric body. EFR was successfully performed in the 34 patients with no need for surgery. The complete resection rate was 100%. Lesion diameter ranged from 1.0 to 5.0 (2.8±1.2) centimeters. The operation time was 50-100 (76.5±18.2) min. Patients with pneumoperitoneum were relieved after abdominal puncture exhaust, without post-operation bleeding and perforation. The hospitalization duration was 3-5 (3.6±0.8) days. Except 1 case, the remaining 33 cases were spindle cell tumors, consistent with the results of immunohistochemistry. The risk for two lesions with 4.5 cm and 5.0 cm was moderate. The risk of invasion was low or very low in the remaining 31 cases. Among them, 2 stromal tumors near the cardia showed a differentiation tendency toward smooth muscle. No lesion residual or recurrence happened during the follow-up period (range 5-23 months) in 34 cases. @*CONCLUSION@#EFR is a safe and effective method for gastric tumor originated from muscularis propria.