Efficacy and Safety of Peroral Endoscopic Myotomy for Treatment of Achalasia After Failed Heller Myotomy.
Обработка статьи · этапы, ошибки и управление
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.
Ngamruengphong Saowanee, Inoue Haruhiro, Ujiki Michael B, Patel Lava Y, Bapaye Amol, Desai Pankaj N, Dorwat Shivangi, Nakamura Jun, Hata Yoshitaka, Balassone Valerio, Onimaru Manabu, Ponchon Thierry, Pioche Mathieu, Roman Sabine, Rivory Jérôme, Mion François, Garros Aurélien, Draganov Peter V, Perbtani Yaseen, Abbas Ali, Pannu Davinderbir, Yang Dennis, Perretta Silvana, Romanelli John, Desilets David, Hayee Bu, Haji Amyn, Hajiyeva Gulara, Ismail Amr, Chen Yen-I, Bukhari Majidah, Haito-Chavez Yamile, Kumbhari Vivek, Saxena Payal, Talbot Michael, Chiu Philip Wai-Yan, Yip Hon-Chi, Wong Vivien Wai-Yin, Hernaez Ruben, Maselli Roberta, Repici Alessandro, Khashab Mouen A
Аннотация
METHODS: We conducted a retrospective cohort study of 180 patients with achalasia who underwent POEM at 13 tertiary centers worldwide, from December 2009 through September 2015. Patients were divided into 2 groups: those with prior HM (HM group, exposure; n = 90) and those without prior HM (non-HM group; n = 90). Clinical response was defined by a decrease in Eckardt scores to 3 or less. Adverse events were graded according to criteria set by the American Society for Gastrointestinal Endoscopy. Technical success, clinical success, and rates of adverse events were compared between groups. Patients were followed up for a median of 8.5 months.
RESULTS: POEM was technically successful in 98% of patients in the HM group and in 100% of patients in the non-HM group (P = .49). A significantly lower proportion of patients in the HM group had a clinical response to POEM (81%) than in the non-HM group (94%; P = .01). There were no significant differences in rates of adverse events between the groups (8% in the HM group vs 13% in the non-HM group; P = .23). Symptomatic reflux and reflux esophagitis after POEM were comparable between groups.
CONCLUSIONS: POEM is safe and effective for patients with achalasia who were not treated successfully by prior HM. Although the rate of clinical success in patients with prior HM is lower than in those without prior HM, the safety profile of POEM is comparable between groups.