Abstract：
OBJECTIVE: Surgical or endoscopic treatments play an essential role in the management of achalasia. The probability of adverse events in the performance of said treatments is a relevant aspect, when establishing the risk-benefit balance. The present study aimed to establish the association between serious adverse events and the performance of those procedures, in adult patients with achalasia.
METHODS: A systemic search of randomized and nonrandomized clinical trials, retrospective cohorts, and cases series on adult patients with achalasia that underwent laparoscopic Heller myotomy (LHM), peroral endoscopic myotomy (POEM), or endoscopic balloon dilation, that reported serious adverse events, was carried out on the Medline, CENTRAL, and EBSCO databases. Serious adverse events were defined as: death at 30 days, Clavien-Dindo grade III or higher classification, esophageal or gastric perforation, pneumothorax, mucosal tear, leakage, emphysema, pneumonia, and chest pain. The methodology included the PRISMA guidelines for reporting systematic reviews.
RESULTS: Thirty-five studies were found that reported information on 1,276 patients that underwent POEM, 5,492 that underwent LHM, and 10,346 that underwent endoscopic balloon dilation. The proportions of adverse events for the three techniques were 3.6, 4.9, and 3.1%, respectively.
CONCLUSIONS: The 3 therapeutic interventions evaluated had similar proportions of adverse events. There were few reports of death at 30 days as an outcome and the lack of standardization in reporting adverse events in the studies analyzed was prominent.
METHODS: A systemic search of randomized and nonrandomized clinical trials, retrospective cohorts, and cases series on adult patients with achalasia that underwent laparoscopic Heller myotomy (LHM), peroral endoscopic myotomy (POEM), or endoscopic balloon dilation, that reported serious adverse events, was carried out on the Medline, CENTRAL, and EBSCO databases. Serious adverse events were defined as: death at 30 days, Clavien-Dindo grade III or higher classification, esophageal or gastric perforation, pneumothorax, mucosal tear, leakage, emphysema, pneumonia, and chest pain. The methodology included the PRISMA guidelines for reporting systematic reviews.
RESULTS: Thirty-five studies were found that reported information on 1,276 patients that underwent POEM, 5,492 that underwent LHM, and 10,346 that underwent endoscopic balloon dilation. The proportions of adverse events for the three techniques were 3.6, 4.9, and 3.1%, respectively.
CONCLUSIONS: The 3 therapeutic interventions evaluated had similar proportions of adverse events. There were few reports of death at 30 days as an outcome and the lack of standardization in reporting adverse events in the studies analyzed was prominent.
摘要：
目的：手术或内镜治疗在贲门失弛缓症的治疗中起着至关重要的作用。在所述治疗的执行中的不良事件的概率是相关的方面。在建立风险收益平衡时。本研究旨在建立严重不良事件与这些程序的执行之间的关联。在成年贲门失弛缓症患者中。
方法：对随机和非随机临床试验的系统搜索，回顾性队列，以及接受腹腔镜Heller肌切开术（LHM）的成年门失弛缓症患者的病例系列，经口内镜肌切开术（POEM），或内窥镜球囊扩张术，报告了严重不良事件，是在Medline上进行的，中部,和EBSCO数据库。严重不良事件定义为：30天死亡，Clavien-Dindo三级或更高级别的分类，食管或胃穿孔，气胸,粘膜撕裂，泄漏,肺气肿,肺炎,和胸痛。该方法包括PRISMA报告系统审查的准则。
结果：35项研究报告了1276例接受POEM的患者的信息，接受LHM的5,492，10346例接受内窥镜球囊扩张术。三种技术的不良事件比例分别为3.6、4.9和3.1％，分别。
结论：评估的3种治疗干预措施的不良事件比例相似。很少有30天死亡作为结果的报告，并且在分析的研究中缺乏报告不良事件的标准化是突出的。
方法：对随机和非随机临床试验的系统搜索，
结果：35项研究报告了1276例接受POEM的患者的信息，
结论：评估的3种治疗干预措施的不良事件比例相似。
