Safety and efficacy of peroral endoscopic myotomy for treating achalasia in pediatric and geriatric patients:A meta-analysis  

作　　者：Xin-Xin Pu Shu Huang Chun-Yu Zhong Xia Wang Su-Fen Fu Ying-Qin Lv Kang Zou Mu-Han Lü Yan Peng Xiao-Wei Tang 

机构地区：[1]Department of Gastroenterology,Dechang People’s Hospital of Sichuan Province,Liangshan 615500,Sichuan Province,China [2]Department of Gastroenterology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China [3]Department of Gastroenterology,Lianshui People’s Hospital of Kangda College Affiliated to Nanjing Medical University,Huaian 223499,Jiangsu Province,China [4]Department of Ultrasound,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China

出　　处：《World Journal of Gastrointestinal Endoscopy》2024年第10期566-580,共15页世界胃肠内镜杂志（英文）

摘　　要：BACKGROUND As a less invasive technique,peroral endoscopic myotomy(POEM)has recently been widely accepted for treating achalasia with an excellent safety profile,durability,and efficacy in adults.In pediatric and geriatric patients,the treatment is more difficult.AIM To discuss the clinical outcomes of POEM in pediatric and geriatric patients with achalasia.METHODS We conducted a comprehensive search of PubMed,Embase and Cochrane Library databases from inception to July 2024.The primary outcomes were technical and clinical success.Secondary outcomes of interest included adverse events and gastroesophageal reflux disease(GERD).The pooled event rates were calculated by comprehensive meta-analysis software.RESULTS A total of 32 studies with 547 pediatric patients and 810 geriatric patients were included in this study.The pooled event rates of technical success,clinical success,GERD and adverse events of POEM for treating achalasia in pediatric patients were 97.1%[95%confidence interval(CI):95.0%-98.3%;I^(2)=0%;P<0.000],93.2%(95%CI:90.5%-95.2%;I^(2)=0%;P<0.000),22.3%(95%CI:18.4%-26.7%;I^(2)=43.874%;P<0.000)and 20.4%(95%CI:16.6%-24.8%;I^(2)=67.217%;P<0.000),respectively.Furthermore,in geriatric patients,the pooled event rates were 97.7%(95%CI:95.8%-98.7%;I^(2)=15.200%;P<0.000),93.2%(95%CI:90.3%-95.2%;I^(2)=0%;P<0.000),23.9%(95%CI:19.4%-29.1%;I^(2)=75.697%;P<0.000)and 10.8%(95%CI:8.3%-14.0%;I^(2)=62.938%;P<0.000],respectively.CONCLUSION Our findings demonstrated that POEM was an effective and safe technique for pediatric and geriatric patients with achalasia.

关 键 词：ACHALASIA Peroral endoscopic myotomy PEDIATRIC GERIATRIC META-ANALYSIS 

分 类 号：R57[医药卫生—消化系统]