Zhang You, Ling-hu Enqiang, Zhai Yaqi, Peng Lihua, Wang Xiaoxiao
Hepatogastroenterology. 2015 Jan-Feb;62(137):82-6.
BACKGROUND/AIMS: To determine the efficacy and safety of circular muscle myotomy plus balloon shaping for achalasia patients.
Peroral endoscopic myotomy plus balloon shaping was performed in 34 patients prospectively. Treatment success, changes in manometry outcomes and in body weight before and after myotomy, complications related to the procedure and reflux symptoms after procedure were analyzed.
Treatment success was achieved in 97% (33/34) of cases at three months after treatment (mean score pre- vs. post-treatment 7.68 vs 0.82; P<0.001) and treatment success rate at 6 and 12 months was 94% (31/33) and 95% (19/20) respectively. Mean lower esophageal sphincter residual pressure was 25.14 mmHg pre-treatment and 10.72 mmHg post-treatment (P<0.001), with 88% (22/25) of patients' postoperative lower esophageal sphincter pressure restored to normal. The post-treatment average body weight of 34 patients was significantly higher than before (64.56 kg vs 60.04 kg, P<0.001). The overall rate of complications related to the procedure was 14.71%. 26.47% of patients developed symptoms of gastroesophageal reflux after procedure.
Peroral endoscopic myotomy plus balloon shaping is an effective treatment for achalasia resulting in sustained treatment success of about 95% during a mean follow-up period of 13.3 months.
背景/目的：确定环形肌切开术联合球囊扩张术治疗贲门失弛缓症患者的疗效和安全性。
对34例患者前瞻性地实施经口内镜下肌切开术联合球囊扩张术。分析治疗成功率、肌切开术前术后食管测压结果及体重变化、与手术相关的并发症以及术后反流症状。
治疗后3个月时，97%（33/34）的病例取得治疗成功（治疗前平均评分为7.68，治疗后为0.82；P<0.001），6个月和12个月时的治疗成功率分别为94%（31/33）和95%（19/20）。治疗前食管下括约肌残余压力平均为25.14 mmHg，治疗后为10.72 mmHg（P<0.001），88%（22/25）的患者术后食管下括约肌压力恢复正常。34例患者治疗后的平均体重显著高于治疗前（64.56 kg对60.04 kg，P<0.001）。与手术相关的并发症总发生率为14.71%。26.47%的患者术后出现胃食管反流症状。
经口内镜下肌切开术联合球囊扩张术是治疗贲门失弛缓症的有效方法，在平均13.3个月的随访期内持续治疗成功率约为95%。
