PDF(Pubmed)
Abstract：
UNASSIGNED: Achalasia can cause disabling symptoms that may substantially impair the quality of life. Peroral endoscopic myotomy (POEM) has shown promising results in the management of achalasia. In this meta-analysis we have evaluated the feasibility and safety of single-session POEM with fundoplication (POEM+F) in patients with achalasia.
UNASSIGNED: We reviewed several databases from inception to July 08, 2022, to identify studies evaluating the feasibility and/or safety of single-session POEM+F for patients with achalasia. Our outcomes of interest included the technical success of POEM+F, adverse events, esophagitis and wrap integrity on follow-up upper endoscopy, total procedure time, and fundoplication time. Pooled rates with 95% confidence intervals (CI) for outcomes were calculated using a random effect model. Heterogeneity was assessed using the I 2 statistic.
UNASSIGNED: We included 4 studies with 90 patients. Pooled rates (95%CI) of technical success and adverse events were 92% (83-96%) and 5% (2-11%), respectively. Pooled rates (95%CI) of esophagitis and wrap integrity on follow-up upper endoscopy were 18% (11-30%) and 85% (43-98%) respectively. Pooled mean procedure time and fundoplication time were 113.2 (98.7-127.6) and 55.3 (43.7-66.8) min, respectively.
UNASSIGNED: This meta-analysis demonstrates the feasibility and safety of POEM+F in patients with achalasia. More studies with long-term follow up are required to further validate these findings.
UNASSIGNED: We reviewed several databases from inception to July 08, 2022, to identify studies evaluating the feasibility and/or safety of single-session POEM+F for patients with achalasia. Our outcomes of interest included the technical success of POEM+F, adverse events, esophagitis and wrap integrity on follow-up upper endoscopy, total procedure time, and fundoplication time. Pooled rates with 95% confidence intervals (CI) for outcomes were calculated using a random effect model. Heterogeneity was assessed using the I 2 statistic.
UNASSIGNED: We included 4 studies with 90 patients. Pooled rates (95%CI) of technical success and adverse events were 92% (83-96%) and 5% (2-11%), respectively. Pooled rates (95%CI) of esophagitis and wrap integrity on follow-up upper endoscopy were 18% (11-30%) and 85% (43-98%) respectively. Pooled mean procedure time and fundoplication time were 113.2 (98.7-127.6) and 55.3 (43.7-66.8) min, respectively.
UNASSIGNED: This meta-analysis demonstrates the feasibility and safety of POEM+F in patients with achalasia. More studies with long-term follow up are required to further validate these findings.
摘要：
■失语症可引起致残症状，可能严重损害生活质量。经口内镜肌切开术（POEM）在门失弛缓症的治疗中显示出可喜的结果。在这项荟萃分析中，我们评估了单节POEM合并胃底折叠术（POEMF）在贲门失弛缓症患者中的可行性和安全性。
■我们回顾了从开始到2022年7月8日的几个数据库，以确定评估单疗程POEM+F治疗贲门失弛缓症患者的可行性和/或安全性的研究。我们感兴趣的成果包括POEM+F的技术成功，不良事件,食管炎和后续上消化道内窥镜检查的包裹完整性，总手术时间,和胃底折叠时间。使用随机效应模型计算结果的集合率和95%置信区间(CI)。使用I2统计量评估异质性。
■我们纳入了4项研究，共90例患者。技术成功率和不良事件的合并率（95CI）分别为92％（83-96％）和5％（2-11％），分别。食管炎的合并率（95CI）和后续上消化道内窥镜检查的包裹完整性分别为18％（11-30％）和85％（43-98％）。合并平均手术时间和胃底折叠时间分别为113.2（98.7-127.6）和55.3（43.7-66.8）分钟，分别。
■这项荟萃分析证明了POEM+F在贲门失弛缓症患者中的可行性和安全性。需要更多的长期随访研究来进一步验证这些发现。
■我们回顾了从开始到2022年7月8日的几个数据库，以确定评估单疗程POEM+F治疗贲门失弛缓症患者的可行性和/或安全性的研究。我们感兴趣的成果包括POEM+F的技术成功，不良事件,食管炎和后续上消化道内窥镜检查的包裹完整性，总手术时间,和胃底折叠时间。使用随机效应模型计算结果的集合率和95%置信区间(CI)。使用I2统计量评估异质性。
■我们纳入了4项研究，共90例患者。技术成功率和不良事件的合并率（95CI）分别为92％（83-96％）和5％（2-11％），分别。食管炎的合并率（95CI）和后续上消化道内窥镜检查的包裹完整性分别为18％（11-30％）和85％（43-98％）。合并平均手术时间和胃底折叠时间分别为113.2（98.7-127.6）和55.3（43.7-66.8）分钟，分别。
■这项荟萃分析证明了POEM+F在贲门失弛缓症患者中的可行性和安全性。需要更多的长期随访研究来进一步验证这些发现。
