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Middle East Journal of Digestive Diseases، جلد ۱۵، شماره ۴، صفحات ۲۳۵-۲۴۱
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عنوان انگلیسی Efficacy and Safety of Peroral Endoscopic Myotomy (POEM) in Achalasia: An Updated Meta-Analysis
چکیده انگلیسی مقاله Background Heller myotomy (HM) has been considered the standard surgical treatment for patients with achalasia. Since the initiation of Peroral Endoscopic Myotomy (POEM), it has represented an alternative for treating patients with achalasia. Over the years, numerous prospective and retrospective studies with POEM use for achalasia have been published. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of POEM in patients with achalasia. Methods Publications investigating the safety and efficacy of POEM in patients with achalasia were searched in Medline, Ovid Journals, Medline non-indexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Pooling was conducted by both fixed and random effects models.  Results The initial search identified 328 reference articles; of these, 34 relevant articles were selected and reviewed. Data was extracted from 20 studies ( n  = 1753) which met the inclusion criteria. In pooled analysis, the clinical success of POEM at 3 months was 94% (95% CI = 93 – 95). The pooled clinical success of POEM at 12 months was 91% (95% CI = 90 – 92). The pooled rate of gastroesophageal reflux disease was 21% (95% CI = 19 – 23), esophagitis was reported in 16% (95% CI = 15 – 18), pneumomediastinum in 4% (95% CI = 3 – 6), cervical emphysema in 12% (95% CI = 10 – 13), pneumoperitoneum in 8% (95% CI = 7 – 10), pneumothorax in 5% (95% CI = 4 – 6), pleural effusion in 3% (95% CI = 2 – 3), post-operative bleeding in 4.29% (95% CI = 1.91 –7.61) and aspiration pneumonia in 3.08% (95% CI = 1.13 – 5.97) of the patients after POEM. Conclusions This meta-analysis suggests that POEM is a highly effective and safe endoscopic treatment for patients with achalasia and a reasonable alternative to HM.
کلیدواژه‌های انگلیسی مقاله Achalasia,Peroral Endoscopic Myotomy,Dysphagia
نویسندگان مقاله | Afshin Khaiser
University of Illinois College of Medicine at Peoria, Illinois


| Muhammad Baig
Boca Raton Regional Hospital, Boca Raton, Florida


| David Forcione
University of Missouri-Columbia, Missouri


| Matthew Bechtold
University of Illinois College of Medicine at Peoria, Illinois


| Srinivas Puli


نشانی اینترنتی http://mejdd.org/index.php/mejdd/article/view/2567
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