Per-oral endoscopic myotomy is safe and effective for pediatric patients with achalasia:A long-term follow-up study  

作　　者：Ya-Wei Bi Xiao Lei Nan Ru Long-Song Li Nan-Jun Wang Bo Zhang Yi Yao En-Qiang Linghu Ning-Li Chai 

机构地区：[1]Department of Gastroenterology,The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China [2]Senior Department of Oncology,The Fifth Medical Center of PLA General Hospital,Beijing 100859,China

出　　处：《World Journal of Gastroenterology》2023年第22期3497-3507,共11页世界胃肠病学杂志（英文版）

基　　金：Supported by National Natural Science Foundation of China,No.82070682。

摘　　要：BACKGROUND Per-oral endoscopic myotomy(POEM)is emerging as a prefer treatment option for pediatric achalasia.However,data are limited on the long-term efficacy of POEM in children and adolescents with achalasia.AIM To evaluate the safety and long-term efficacy of POEM for pediatric patients with achalasia and compare those outcomes with adult patients.METHODS This retrospective cohort study was conducted in patients with achalasia who underwent POEM.Patients aged under 18 years were included in the pediatric group;patients aged between 18 to 65 years who underwent POEM in the same period were assigned to the control group.For investigation of long-term followup,the pediatric group were matched with patients from the control group in a 1:1 ratio.The procedure-related parameters,adverse events,clinical success,gastroesophageal reflux disease(GERD)after POEM,and quality of life(QoL)were evaluated.RESULTS From January 2012 to March 2020,POEM was performed in 1025 patients aged under 65 years old(48 in the pediatric group,1025 in the control group).No significant differences were observed in the occurrence of POEM complications between the two groups(14.6%vs 14.6%;P=0.99).Among the 34 pediatric patients(70.8%)who underwent follow-up for 5.7 years(range 2.6-10.6 years),clinical success was achieved in 35 patients(35/36;97.2%).No differences were observed in post-POEM GERD occurrence(17.6%vs 35.3%;P=0.10).QoL was significantly improved in both groups after POEM.CONCLUSION POEM is safe and effective for pediatric patients with achalasia.It can achieve significant symptoms relief and improve QoL.

关 键 词：ACHALASIA PEDIATRIC Per-oral endoscopic myotomy Long-term outcomes 

分 类 号：R725.7[医药卫生—儿科]