加拿大经口内镜下肌切开术经验：首批50例患者
The Canadian POEM Experience: The First 50 Patients.
作者信息
Rai Mandip, Woo Matthew, Bechara Robert
机构信息
Division of Gastroenterology, Queen's University, Ontario, Canada.
Division of Gastroenterology, University of Calgary, Alberta, Canada; Division of Gastroenterology, Queen's University, Ontario, Canada.
出版信息
J Can Assoc Gastroenterol. 2020 Jun 12;4(3):110-114. doi: 10.1093/jcag/gwaa018. eCollection 2021 Jun.
BACKGROUND AND AIMS
Peroral endoscopic myotomy (POEM) has emerged as a less invasive technique for performing myotomy in patients with achalasia. This study aims to assess the safety and efficacy of POEM in a Canadian tertiary care center.
METHODS
All consecutive patients who underwent POEM between March 2016 and May 2018 at a tertiary center were included. The primary outcome of the study was clinical success rate of POEM defined as a post-POEM Eckardt score ≤3 at ≥3 months. Adverse events were recorded according to the Clavien-Dindo grading system.
RESULTS
A total of 50 consecutive patients underwent 51 POEM procedures with a mean procedure length of 85.6 ± 29.6 min. Post-POEM Eckardt scores of ≤3 at ≥3 months was achieved in 98% of patients. The incidence of pathologic reflux post-poem was 23%. The median length of hospital stay was 1 day. No major adverse events occurred.
INTERPRETATION
POEM is a safe and effective procedure for the treatment of achalasia. At a median follow-up of 19.5 months, 98% of patients had sustained clinical response (Eckardt score ≤3).
背景与目的
经口内镜下肌切开术（POEM）已成为治疗贲门失弛缓症患者肌切开术的一种侵入性较小的技术。本研究旨在评估POEM在加拿大一家三级医疗中心的安全性和有效性。
方法
纳入2016年3月至2018年5月在一家三级中心接受POEM治疗的所有连续患者。该研究的主要结局是POEM的临床成功率，定义为术后≥3个月时Eckardt评分≤3。根据Clavien-Dindo分级系统记录不良事件。
结果
共有50例连续患者接受了51次POEM手术，平均手术时长为85.6±29.6分钟。98%的患者在术后≥3个月时Eckardt评分≤3。POEM术后病理性反流的发生率为23%。中位住院时长为1天。未发生重大不良事件。
结论
POEM是一种治疗贲门失弛缓症的安全有效的手术方法。在中位随访19.5个月时，98%的患者有持续的临床反应（Eckardt评分≤3）。
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