腹胀症,以食管下括约肌(LES)松弛受损和蠕动失败为特征,突出是最广泛认可的原发性食管运动障碍。它表现为吞咽困难,固体和液体食物,胸痛,返流,和减肥,导致严重的发病率和医疗负担。传统上,手术Heller肌切开术和充气扩张术是贲门失弛缓症的主要治疗方法。然而,2009年,Inoue和他的同事介绍了一种开创性的内镜技术,称为经口内镜肌切开术(POEM),彻底改变了这种状况的管理。这篇综述旨在全面研究POEM技术在诊断为门失弛缓症患者中的最新进展。深入研究关键方面,比如肌肉切开术的剪裁,预防术中不良事件(AE),对长期结果的评估,以及在治疗失败的情况下再治疗的可行性。
Achalasia, characterized by impaired lower esophageal sphincter (LES) relaxation and failed peristalsis, stands out as the most widely recognized primary esophageal motility disorder. It manifests with dysphagia to solid and liquid foods, chest pain, regurgitation, and weight loss, leading to significant morbidity and healthcare burden. Traditionally, surgical Heller
myotomy and pneumatic dilation were the primary therapeutic approaches for achalasia. However, in 2009, Inoue and colleagues introduced a groundbreaking endoscopic technique called peroral endoscopic
myotomy (POEM), revolutionizing the management of this condition. This review aims to comprehensively examine the recent advancements in the POEM technique for patients diagnosed with achalasia, delving into critical aspects, such as the tailoring of the
myotomy, the prevention of intraprocedural adverse events (AEs), the evaluation of long-term outcomes, and the feasibility of retreatment in cases of therapeutic failure.