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贲门失弛缓症患者经口内镜下肌切开术中部分全层肌切开术与环形肌肌切开术的临床结局及安全性比较

Clinical Outcomes and Safety of Partial Full-Thickness Myotomy versus Circular Muscle Myotomy in Peroral Endoscopic Myotomy for Achalasia Patients.

作者信息

Li Chenyu, Gong Aixia, Zhang Jingwen, Duan Zhijun, Ge Linmei, Xia Nan, Leng Jing, Li Mei, Liu Yanjie

机构信息

Department of Digestive Endoscopy, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116000, China.

Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116000, China.

出版信息

Gastroenterol Res Pract. 2017;2017:2676513. doi: 10.1155/2017/2676513. Epub 2017 Feb 21.

Abstract

Here we aimed to evaluate and compare the efficacy and safety between partial full-thickness myotomy and circular muscle myotomy during POEM procedure in achalasia patients. Clinical data of achalasia of cardia (AC) patients who underwent POEM in our center during January 2014 to January 2015 was collected (34 cases). 19 patients who received partial full-thickness myotomy were assigned to group A and 14 patients who received circular muscle myotomy were assigned to group B. The procedure-related parameters between the two groups were compared. Symptom relief rate and postprocedure manometry outcomes were compared to evaluate the efficacy. Procedure-related adverse events and complications were compared to evaluate the safety. (1) Mean operation times were significantly shorter in group A than group B (62.42 ± 23.17 87.86 ± 26.44 min, < 0.01). (2) Symptom relief rate and postprocedure manometry outcomes had no statistical differences when compared between the two groups (all > 0.05). (3) Comparison of procedure-related adverse events and complications had no statistical differences (all > 0.05). Partial full-thickness myotomy had no significant differences in efficacy or safety with circular myotomy, but partial full-thickness myotomy significantly reduced the procedure time.

摘要

本研究旨在评估和比较贲门失弛缓症患者行经口内镜下肌切开术(POEM)时,部分全层肌切开术与环形肌肌切开术的疗效和安全性。收集了2014年1月至2015年1月在本中心接受POEM治疗的贲门失弛缓症(AC)患者的临床资料(34例)。19例行部分全层肌切开术的患者被分配到A组,14例行环形肌肌切开术的患者被分配到B组。比较两组之间的手术相关参数。比较症状缓解率和术后测压结果以评估疗效。比较手术相关不良事件和并发症以评估安全性。(1)A组的平均手术时间显著短于B组(62.42±23.17对87.86±26.44分钟,P<0.01)。(2)两组之间比较时,症状缓解率和术后测压结果无统计学差异(均P>0.05)。(3)手术相关不良事件和并发症的比较无统计学差异(均P>0.05)。部分全层肌切开术与环形肌切开术在疗效或安全性方面无显著差异,但部分全层肌切开术显著缩短了手术时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/346e/5339530/b5e9284616a2/GRP2017-2676513.001.jpg

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