Abstract：
Peroral endoscopic myotomy (POEM) has revolutionized the therapeutic strategy for achalasia with promising results. We conducted this meta-analysis to compare clinical outcomes between Eastern and Western countries. A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science and Cochrane Library databases to query for studies that assessed the efficacy of POEM for achalasia. All articles published from inception to December 31, 2021 were included. The primary outcome was the pooled clinical success rate. The secondary outcomes included the pooled technical success rate, incidence of adverse events, procedure time and hospital stay. Eighteen Eastern studies involving 5962 patients and 11 Western studies involving 1651 patients were included. The pooled clinical success rate and technical success rate for POEM was equal in the Eastern studies compared to Western studies. The pooled incidence of procedure adverse events for POEM was a little lower in the Eastern studies compared to Western studies (6.6% vs. 8.7%). Similarly, the incidence of reflux-related adverse events was lower in Eastern studies than that in Western studies. The pooled procedure time of POEM was shorter in Eastern studies compared to Western studies (61 minutes vs. 80 minutes), while the length of hospital stay was longer in Eastern studies compared to Western studies (5.8 days vs. 2.4 days). Overall, Eastern countries have the similar POEM outcomes compared to Western countries. However, Eastern countries still need to do more to reduce the length of hospital stay.
摘要：
经口内镜肌切开术（POEM）彻底改变了贲门失弛缓症的治疗策略，并取得了有希望的结果。我们进行了这项荟萃分析，以比较东西方国家之间的临床结果。在PubMed进行了全面的文献检索，EMBASE,WebofScience和CochraneLibrary数据库查询评估POEM对贲门失弛缓症疗效的研究。包括从成立到2021年12月31日发表的所有文章。主要结果是合并的临床成功率。次要结果包括汇总技术成功率，不良事件的发生率，手术时间和住院时间。包括18项涉及5962例患者的东部研究和11项涉及1651例患者的西方研究。与西方研究相比，东方研究中POEM的合并临床成功率和技术成功率相等。与西方研究相比，东方研究中POEM的手术不良事件的合并发生率略低（6.6％vs.8.7%）。同样，东部研究的反流相关不良事件发生率低于西部研究.与西方研究相比，东方研究的POEM合并手术时间较短(61分钟vs.80分钟），而与西方研究相比，东方研究的住院时间更长(5.8天vs.2.4天）。总的来说,与西方国家相比，东方国家的POEM结果相似。然而,东方国家仍然需要做更多的事情来减少住院时间。
