Efficacy of peroral endoscopic myotomyin in treatment of achalasia: analysis of 30 cases / 中国内镜杂志

ABSTRACT

Objective?To observe the clinical efficacy of peroral endoscopic myotomy (POEM) in treatment of achalasia of cardia (AC).?Methods?30 patients with AC were enrolled and treated with POEM from March 2013 to June 2017.?Results?All the 30 cases underwent surgery of POEM successfully. There was 3 cases of subcutaneous emphysema, 2 cases of mild sternal discomfort, 4 cases of post-operative fever and 1 case of delayed hemorrhage in the upper gastrointestinal tract. The Eckardt score (1.1 ± 0.6) was significantly lower than that before operation (5.2 ± 1.3) (P < 0.05). Postoperative BMI (22.6 ± 2.9) kg/m2 was significantly higher than preoperative (19.2 ± 1.8) kg/m2 (P < 0.05). Of the esophageal dynamic index, lower esophageal sphincter pressure (LESP) after operation (18.2 ± 9.5) mmHg was significantly lower than pre-operation (46.7 ± 15.8) mmHg (P < 0.05). Integrated relaxation pressure (IRP) after operation (10.5 ± 2.5) mmHg was significantly lower than pre-operation (22.8 ± 8.3) mmHg (P < 0.05). Length of lower esophageal sphincter (LESL) after operation (2.5 ± 0.5) cm was shorter than pre-operation (2.9 ± 0.8) cm (P < 0.05). Upper esophageal sphincter pressure (UESP) and length of upper esophageal sphincter (UESL) had no significant difference before and after operation (P > 0.05).?Conclusion?POEM is an effective treatment for AC, its short-term effect is affirmed, and its safety is relatively high, part of esophageal dynamic indexes were improved. Long-term efficacy and complications of POEM still need large sample to further follow-up.