Résumé
Objective To observe the changes of esophageal pressure in patients with achalasia (AC) before and after peroral endoscopic myotomy (POEM), and to explore the value of high-resolution manometry (HRM) in evaluating the efficacy of POEM. Methods 38 cases were diagnosed as achalasia and treated with POEM from August 2015 to November 2016. Upper esophageal sphincter resting pressure (UESP), lower esophageal sphincter resting pressure (LESP), esophageal sphincter 4s integrated relaxation pressure (4sIRP) were detected by HRM before operation, at 1 week, 1 month after operation to evaluate the efficacy. Results A total of 38 patients with AC received POEM. At one week, one month after operation, the UESP were (45.34 ± 26.52) mmHg, (41.27 ± 20.09) mmHg, compared with that of before operation (49.58 ± 26.47) mmHg and the differences were not statistically significant. The differences in LESP, 4sIRP between before operation and at one week, one month after operation were statistically significant, P < 0.05. The differences in UESP, LESP and 4sIRP between 1 week and 1 month after operation were not statistically significant. Conclusion The pressure of lower esophageal sphincter was significantly reduced and the dysphagia was improved. HRM might play an important role in the assessment of AC received POEM.
Résumé
Objective To observe the changes of esophageal pressure in patients with achalasia (AC) before and after peroral endoscopic myotomy (POEM), and to explore the value of high-resolution manometry (HRM) in evaluating the efficacy of POEM. Methods 38 cases were diagnosed as achalasia and treated with POEM from August 2015 to November 2016. Upper esophageal sphincter resting pressure (UESP), lower esophageal sphincter resting pressure (LESP), esophageal sphincter 4s integrated relaxation pressure (4sIRP) were detected by HRM before operation, at 1 week, 1 month after operation to evaluate the efficacy. Results A total of 38 patients with AC received POEM. At one week, one month after operation, the UESP were (45.34 ± 26.52) mmHg, (41.27 ± 20.09) mmHg, compared with that of before operation (49.58 ± 26.47) mmHg and the differences were not statistically significant. The differences in LESP, 4sIRP between before operation and at one week, one month after operation were statistically significant, P < 0.05. The differences in UESP, LESP and 4sIRP between 1 week and 1 month after operation were not statistically significant. Conclusion The pressure of lower esophageal sphincter was significantly reduced and the dysphagia was improved. HRM might play an important role in the assessment of AC received POEM.