Surgical endoscopy · 2026
Long-term outcomes of peroral endoscopic myotomy for achalasia: a systematic review and meta-analysis with median follow-up ≥ 5 years.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chen Yuxin, Chen Yifei, Lv Bin
Аннотация
BACKGROUND: Peroral Endoscopic Myotomy (POEM) has become the first-line minimally invasive treatment for achalasia. Its short-term and mid-term (1-5 years) efficacy has been consistently demonstrated, but long-term follow-up data (≥ 5 years) remain limited. This systematic review and meta-analysis aims to comprehensively evaluate the long-term (median follow-up ≥ 5 years) clinical efficacy and safety of POEM.
METHODS: Using medical literature databases, we retrieved randomized controlled trials (RCTs) and non-randomized comparative studies from the inception of the databases through September 2025. Data were extracted using the Cochrane Risk of Bias 2.0 tool and the Newcastle-Ottawa Scale to assess risk of bias for RCTs and cohort studies, respectively. Meta-analyses were conducted using either fixed-effect or random-effects models.
RESULTS: A total of 16 studies involving 2421 patients (50.4% male) were included, with a median follow-up duration of 72 months (range, 60-144 months). The pooled clinical success rate was 87.1% (95% CI 82.4-91.8%; I2 = 84.2%). The pooled incidence of endoscopically detectable reflux esophagitis was 24.2% (95% CI 11.6-36.8%; I2 = 85.4%), whereas symptomatic reflux was inconsistently reported, with a pooled incidence of 27.2% (95% CI 19.2-35.3%; I2 = 83.6%). Long-term follow-up reported 2 cases of Barrett's esophagus and isolated cases of esophageal cancer.
CONCLUSION: POEM has demonstrated consistent long-term efficacy and safety. Postoperative symptomatic reflux is the most common long-term complication, while the risks of Barrett's esophagus and peptic stricture remain low. POEM represents a reliable first-line treatment option; however, further multicenter prospective studies are needed to validate its long-term efficacy and safety.
METHODS: Using medical literature databases, we retrieved randomized controlled trials (RCTs) and non-randomized comparative studies from the inception of the databases through September 2025. Data were extracted using the Cochrane Risk of Bias 2.0 tool and the Newcastle-Ottawa Scale to assess risk of bias for RCTs and cohort studies, respectively. Meta-analyses were conducted using either fixed-effect or random-effects models.
RESULTS: A total of 16 studies involving 2421 patients (50.4% male) were included, with a median follow-up duration of 72 months (range, 60-144 months). The pooled clinical success rate was 87.1% (95% CI 82.4-91.8%; I2 = 84.2%). The pooled incidence of endoscopically detectable reflux esophagitis was 24.2% (95% CI 11.6-36.8%; I2 = 85.4%), whereas symptomatic reflux was inconsistently reported, with a pooled incidence of 27.2% (95% CI 19.2-35.3%; I2 = 83.6%). Long-term follow-up reported 2 cases of Barrett's esophagus and isolated cases of esophageal cancer.
CONCLUSION: POEM has demonstrated consistent long-term efficacy and safety. Postoperative symptomatic reflux is the most common long-term complication, while the risks of Barrett's esophagus and peptic stricture remain low. POEM represents a reliable first-line treatment option; however, further multicenter prospective studies are needed to validate its long-term efficacy and safety.