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首页> 外文期刊>Endoscopy International Open >Peroral endoscopic myotomy (POEM) vs laparoscopic Heller myotomy (LHM) for the treatment of Type III achalasia in 75 patients: a multicenter comparative study
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Peroral endoscopic myotomy (POEM) vs laparoscopic Heller myotomy (LHM) for the treatment of Type III achalasia in 75 patients: a multicenter comparative study

机译：经口内镜下肌切开术（POEM）与腹腔镜Heller肌切开术（LHM）治疗75例III型门失弛缓症：一项多中心比较研究

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Background and study aims: Type III achalasia is characterized by rapidly propagating pressurization attributable to spastic contractions. Although laparoscopic Heller myotomy (LHM) is the current gold standard management for type III achalasia, peroral endoscopic myotomy (POEM) is conceivably superior because it allows for a longer myotomy. Our aims were to compare the efficacy and safety of POEM with LHM for type III achalasia patients. Patients and methods: A retrospective study of 49 patients who underwent POEM for type III achalasia across eight centers were compared to 26 patients who underwent LHM at a single institution. Procedural data were abstracted and pre- and post-procedural symptoms were recorded. Clinical response was defined by improvement of symptoms and decrease in Eckardt stage to ≤?1.?Secondary outcomes included length of myotomy, procedure duration, length of hospital stay, and rate of adverse events. Results: Clinical response was significantly more frequent in the POEM cohort (98.0?% vs 80.8?%; P?=?0.01). POEM patients had significantly shorter mean procedure time than LHM patients (102?min vs 264 min; P?
机译：背景和研究目的：III型门失弛缓症的特征是由于痉挛性收缩而迅速传播加压。尽管腹腔镜Heller肌切开术（LHM）是目前治疗III型门失弛缓症的金标准，但经口内镜下肌切开术（POEM）可以认为是更好的选择，因为它允许更长的肌切开。我们的目的是比较POEM与LHM对III型失弛缓症患者的疗效和安全性。患者和方法：回顾性研究了在八个中心对49名接受POEM治疗III型III门失弛缓症的患者与26名在单个机构接受LHM治疗的患者的比较。提取过程数据，并记录术前和术后症状。临床反应的定义是症状改善，Eckardt分期降低到≤1。次要结果包括切肌时间，手术时间，住院时间和不良事件发生率。结果：POEM队列中的临床反应明显更为频繁（98.0％vs 80.8％; P = 0.01）。尽管肌切开术的长度更长（16？cm vs 8 cm; P 0.01），但POEM患者的平均手术时间却明显短于LHM患者（102？min vs 264 min; P 0.01）。 POEM和LHM在住院时间方面无显着差异（分别为3.3天和3.2天; P = 0.68）。 POEM组的不良事件发生率显着降低（6％vs. 27％; P 0.01）。结论：POEM允许的肌切开术比LHM更长，这可能会改善临床结果。对于III型门失弛缓患者，POEM似乎是LHM的有效替代品。

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