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

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 

作者机构：Department of GastroenterologyDechang People’s Hospital of Sichuan ProvinceLiangshan 615500Sichuan ProvinceChina Department of GastroenterologyThe Affiliated Hospital of Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina Department of GastroenterologyLianshui People’s Hospital of Kangda College Affiliated to Nanjing Medical UniversityHuaian 223499Jiangsu ProvinceChina Department of UltrasoundThe Affiliated Hospital of Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2024年第16卷第10期

页      面：566-580页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Achalasia Peroral endoscopic myotomy Pediatric Geriatric Meta-analysis 

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 *** pediatric and geriatric patients,the treatment is more *** To discuss the clinical outcomes of POEM in pediatric and geriatric patients with *** We conducted a comprehensive search of PubMed,Embase and Cochrane Library databases from inception to July *** primary outcomes were technical and clinical *** outcomes of interest included adverse events and gastroesophageal reflux disease(GERD).The pooled event rates were calculated by comprehensive meta-analysis *** A total of 32 studies with 547 pediatric patients and 810 geriatric patients were included in this *** 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%;I²=0%;P0.000],93.2%(95%CI:90.5%-95.2%;I²=0%;P0.000),22.3%(95%CI:18.4%-26.7%;I²=43.874%;P0.000)and 20.4%(95%CI:16.6%-24.8%;I²=67.217%;P0.000),***,in geriatric patients,the pooled event rates were 97.7%(95%CI:95.8%-98.7%;I²=15.200%;P0.000),93.2%(95%CI:90.3%-95.2%;I²=0%;P0.000),23.9%(95%CI:19.4%-29.1%;I²=75.697%;P0.000)and 10.8%(95%CI:8.3%-14.0%;I²=62.938%;P0.000],*** Our findings demonstrated that POEM was an effective and safe technique for pediatric and geriatric patients with achalasia.