PDF(Pubmed)
Abstract：
A novel treatment method for achalasia of the esophagus and related disorders is known as peroral endoscopic myotomy (POEM). This study aimed to calculate the resting energy expenditure (REE) and evaluated the degree of physical invasiveness based on metabolic changes during the perioperative period of POEM. Fifty-eight patients who underwent POEM were prospectively enrolled; REE, body weight (BW), and basal energy expenditure were measured on the day of POEM, postoperative day 1 (POD 1), and three days after POEM (POD 3). The median REE/BW increased from 19.6 kcal/kg on the day of POEM to 24.5 kcal/kg on POD 1. On POD 3, it remained elevated at 20.9 kcal/kg. The stress factor on POD 1 was 1.20. Among the factors, including the Eckardt score, operation time, and the length of myotomy, the length of myotomy was associated with changes in REE/BW. During the perioperative period of POEM, the level of variation in energy expenditure was lower than that of esophageal cancer surgeries performed under general anesthesia. However, because the length of myotomy is a factor affecting changes in energy expenditure, careful perioperative management is desirable for patients with longer myotomy lengths.
摘要：
食道门失弛缓症和相关疾病的新治疗方法被称为经口内窥镜肌切开术（POEM）。这项研究旨在计算静息能量消耗（REE），并根据POEM围手术期的代谢变化评估身体侵入程度。58名接受POEM的患者被前瞻性地纳入；REE，体重(BW),基础能量消耗是在POEM当天测量的，术后第1天（POD1），和POEM（POD3）后三天。REE/BW中位数从POEM当天的19.6kcal/kg增加到POD1的24.5kcal/kg。在POD3上，它仍然升高到20.9kcal/kg。POD1上的应激因子为1.20。在这些因素中，包括Eckardt的分数,操作时间,以及肌切开术的长度，肌切开术的长度与REE/BW的变化相关.在POEM的围手术期，能量消耗的变化水平低于在全身麻醉下进行的食管癌手术。然而,因为肌切开术的长度是影响能量消耗变化的一个因素，对于肌切开术长度较长的患者，应谨慎进行围手术期处理。
