Peroral endoscopic myotomy for achalasia and patients with normal lower-esophageal-sphincter integrated relaxation pressure:A propensity-score-matched retrospective study  

作　　者：Xiao Li Xiao-Bin Zhang Jia-Kang Shao Bo Zhang Long-Song Li Rui-Qing Zhu Jia-Le Zou Jia-Feng Wang Xin Zhao Qing-Zhen Wu Ning-Li Chai En-Qiang Linghu 

机构地区：[1]Department of General Medicine,The Fourth Medical Center of Chinese PLA General Hospital,Beijing 100048,China [2]Department of Gastroenterology,The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China

出　　处：《World Journal of Gastroenterology》2025年第12期27-36,共10页世界胃肠病学杂志(英文)

摘　　要：BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the clinical symptoms of achalasia associated with increased LES pressure.AIM To identify the safety and efficacy of POEM for patients with normal LES integrated relaxation pressure(LES-IRP).METHODS The clinical data of patients who underwent POEM successfully in The First Medical Center of Chinese PLA General Hospital were retrospectively analyzed.A total of 481 patients who underwent preoperative high-resolution manometry(HRM)at our hospital were ultimately included in this research.According to the HRM results,the patients were divided into two groups:71 patients were included in the normal LES-IRP group(LES-IRP<15 mmHg)and 410 patients were included in the increased LES-IRP group(LES-IRP≥15 mmHg).Clinical characteristics,procedure-related parameters,adverse events,and outcomes were compared between the two groups to evaluate the safety and efficacy of POEM for patients with normal LES-IRP.RESULTS Among the 481 patients included in our study,209 were males and 272 were females,with a mean age of 44.2 years.All patients underwent POEM without severe adverse events.The median pre-treatment Eckardt scores of the normal LES-IRP and increased LES-IRP groups were 7.0 and 7.0(P=0.132),respectively,decreasing to 1.0 and 1.0 post-treatment(P=0.572).The clinical success rate of the normal LES-IRP group was 87.3%(62/71),and that of the increased LES-IRP group was 91.2%(374/410)(P=0.298).Reflux symptoms were measured by the GerdQ questionnaire,and the percentages of patients with GerdQ scores≥9 in the normal LES-IRP and increased LES-IRP groups were 8.5%and 10.7%,respectively(P=0.711).After matching,the rates of clinical success and the rates of GerdQ score≥9 were not significantly different between the two groups.CONCLUSION Our results suggest that POEM is safe and effective for achalasia and patients with no

关 键 词：Peroral endoscopic myotomy ACHALASIA Lower esophageal sphincter integrated relaxation pressure Safety Efficacy 

分 类 号：R57[医药卫生—消化系统]