经口内镜肌切开术治疗食管憩室：系统评价和荟萃分析。
Peroral Endoscopic Myotomy for the Treatment of Esophageal Diverticula: A Systematic Review and Meta-analysis.
机构信息
Gastroenterology Unit, University of Foggia, Foggia, Italy.
Division of Gastroenterology and Hepatology, University of Utah, Salt Lake, Utah.
出版信息
J Clin Gastroenterol. 2022;56(10):853-862. doi: 10.1097/MCG.0000000000001622. Epub 2021 Oct 4.
BACKGROUND
There is limited evidence on the efficacy of peroral endoscopic myotomy (POEM) in patients with esophageal diverticula.
AIMS
This meta-analysis aimed to assess the efficacy and safety profile of POEM in patients with Zenker (ZD) and epiphrenic diverticula.
METHODS
With a literature search through August 2020, we identified 12 studies (300 patients) assessing POEM in patients with esophageal diverticula. The primary outcome was treatment success. Results were expressed as pooled rates and 95% confidence intervals.
RESULTS
Pooled rate of technical success was 95.9% (93.4%-98.3%) in ZD patients and 95.1% (88.8%-100%) in patients with epiphrenic diverticula. Pooled rate of treatment success was similar for ZD (90.6%, 87.1%-94.1%) and epiphrenic diverticula (94.2%, 87.3%-100%). Rates of treatment success were maintained at 1 year (90%, 86.4%-97.4%) and 2 years (89.6%, 82.2%-96.9%) in ZD patients. Pooled rate of symptom recurrence was 2.6% (0.9%-4.4%) in ZD patients and 0% in patients with epiphrenic diverticula. Pooled rates of adverse events and severe adverse events were 10.6% (4.6%-16.6%) and 3.5% (0%-7.4%) in ZD and 8.4% (0%-16.8%) and 8.4% (0%-16.8%) in epiphrenic diverticula, respectively.
CONCLUSION
POEM represents an effective and safe therapy for the treatment of esophageal diverticula.
背景
经口内镜下肌切开术（POEM）治疗食管憩室的疗效证据有限。
目的
本荟萃分析旨在评估 POEM 治疗Zenker（ZD）和膈上憩室的疗效和安全性。
方法
通过 2020 年 8 月的文献检索，我们确定了 12 项评估 POEM 治疗食管憩室患者的研究（300 例患者）。主要结局是治疗成功。结果以汇总率和 95%置信区间表示。
结果
在 ZD 患者中，POEM 的技术成功率为 95.9%（93.4%-98.3%），膈上憩室患者为 95.1%（88.8%-100%）。ZD（90.6%，87.1%-94.1%）和膈上憩室（94.2%，87.3%-100%）的治疗成功率相似。在 ZD 患者中，1 年（90%，86.4%-97.4%）和 2 年（89.6%，82.2%-96.9%）的治疗成功率保持不变。ZD 患者的症状复发率为 2.6%（0.9%-4.4%），膈上憩室患者为 0%。ZD 患者的不良事件和严重不良事件发生率分别为 10.6%（4.6%-16.6%）和 3.5%（0%-7.4%），膈上憩室患者分别为 8.4%（0%-16.8%）和 8.4%（0%-16.8%）。
结论
POEM 是治疗食管憩室的一种有效且安全的治疗方法。
Zotero 插件