PDF(Pubmed)
Abstract：
UNASSIGNED: A cricopharyngeal bar refers to a radiological description of a prominent cricopharyngeal muscle. While these may be incidental, they can lead to significant oropharyngeal dysphagia due to incoordination of the upper esophageal sphincter and true luminal narrowing. Various treatments have been used for the management of cricopharyngeal bar, including botulinum toxin injection, dilation, and surgical myotomy. Cricopharyngeal peroral endoscopic myotomy (C-POEM) is a novel procedure that uses the principles of \"third-space\" endoscopy to treat symptomatic cricopharyngeal bar.
UNASSIGNED: We report a retrospective case series of 5 patients referred with oropharyngeal dysphagia to 2 UK tertiary referral centers between 2022 and 2023 who subsequently underwent C-POEM. Technical success was defined as completion of all steps of the C-POEM procedure and clinical success as a reduction in the pre-treatment Dakkak and Bennett score to ≤1, or 0 if the pre-treatment score was 1.
UNASSIGNED: C-POEM was associated with a technical success of 100% and clinical success of 100% over a median follow up of 2 months (interquartile range 1-8). There was 1 adverse event due to a small mucosal defect and associated leak on barium swallow, which was the result of difficult access during mucosal closure. This was managed conservatively with antibiotics. A step-by-step video demonstration of the procedure is provided.
UNASSIGNED: C-POEM offers an alternative upfront therapy for symptomatic cricopharyngeal bar, but should be undertaken by endoscopists with significant experience in third-space endoscopy in view of the difficulty of working within the hypopharynx.
UNASSIGNED: We report a retrospective case series of 5 patients referred with oropharyngeal dysphagia to 2 UK tertiary referral centers between 2022 and 2023 who subsequently underwent C-POEM. Technical success was defined as completion of all steps of the C-POEM procedure and clinical success as a reduction in the pre-treatment Dakkak and Bennett score to ≤1, or 0 if the pre-treatment score was 1.
UNASSIGNED: C-POEM was associated with a technical success of 100% and clinical success of 100% over a median follow up of 2 months (interquartile range 1-8). There was 1 adverse event due to a small mucosal defect and associated leak on barium swallow, which was the result of difficult access during mucosal closure. This was managed conservatively with antibiotics. A step-by-step video demonstration of the procedure is provided.
UNASSIGNED: C-POEM offers an alternative upfront therapy for symptomatic cricopharyngeal bar, but should be undertaken by endoscopists with significant experience in third-space endoscopy in view of the difficulty of working within the hypopharynx.
摘要：
■环咽棒是指对突出的环咽肌的放射学描述。虽然这些可能是偶然的，由于食管上括约肌不协调和真正的管腔狭窄，它们可导致严重的口咽部吞咽困难。各种治疗方法已用于环咽棒的管理，包括肉毒杆菌毒素注射,膨胀,和手术肌切开术。环咽经口内镜肌切开术（C-POEM）是一种新颖的方法，它使用“第三空间”内窥镜检查的原理来治疗有症状的环咽棒。
■我们报告了一个回顾性病例系列，其中5例患者在2022年至2023年期间转诊到英国2个三级转诊中心，随后接受了C-POEM。技术成功定义为完成C-POEM程序的所有步骤，临床成功定义为治疗前Dakkak和Bennett评分降低至≤1，如果治疗前评分为1，则为0。
■C-POEM在2个月的中位随访时间（四分位数范围1-8）内，技术成功率为100％，临床成功率为100％。有1个不良事件是由于一个小的粘膜缺损和相关的钡吞咽渗漏。这是粘膜闭合过程中难以接近的结果。这是用抗生素保守地管理的。提供了该过程的逐步视频演示。
■C-POEM为有症状的环咽棒提供了一种替代的前期治疗，但鉴于在下咽部工作的困难，应由在第三空间内窥镜检查方面具有丰富经验的内窥镜医师进行。
■我们报告了一个回顾性病例系列，其中5例患者在2022年至2023年期间转诊到英国2个三级转诊中心，随后接受了C-POEM。技术成功定义为完成C-POEM程序的所有步骤，临床成功定义为治疗前Dakkak和Bennett评分降低至≤1，如果治疗前评分为1，则为0。
■C-POEM在2个月的中位随访时间（四分位数范围1-8）内，技术成功率为100％，临床成功率为100％。有1个不良事件是由于一个小的粘膜缺损和相关的钡吞咽渗漏。这是粘膜闭合过程中难以接近的结果。这是用抗生素保守地管理的。提供了该过程的逐步视频演示。
■C-POEM为有症状的环咽棒提供了一种替代的前期治疗，但鉴于在下咽部工作的困难，应由在第三空间内窥镜检查方面具有丰富经验的内窥镜医师进行。
