PMID- 35401740
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220413
IS  - 1687-6121 (Print)
IS  - 1687-630X (Electronic)
IS  - 1687-6121 (Linking)
VI  - 2022
DP  - 2022
TI  - Safety and Efficacy of Peroral Endoscopic Shorter Myotomy versus Longer Myotomy 
      for Patients with Achalasia: A Systematic Review and Meta-analysis.
PG  - 6770864
LID - 10.1155/2022/6770864 [doi]
LID - 6770864
AB  - BACKGROUND AND AIMS: The adequate myotomy length during peroral endoscopic 
      myotomy (POEM) is still controversial. We performed this systematic review and 
      meta-analysis to determine the efficacy and safety of the modified POEM with 
      shorter myotomy (SM) and compare the outcomes between SM and longer myotomy (LM) 
      in achalasia patients. METHODS: A comprehensive literature search was conducted 
      in PubMed, EMBASE, Cochrane Library, and Web of Science databases from inception 
      to May 28, 2021. The primary outcome was clinical success rate and incidence of 
      reflux-relative adverse events (AEs). Fixed- or random-effect models were adopted 
      for the analysis according to the heterogeneity. RESULTS: Five studies involving 
      225 patients in SM group and 222 patients in LM group were included. The overall 
      clinical success of SM was 96.6% (95% confidence interval (CI) 92.7 to 98.4%). SM 
      showed noninferior response as compared to LM (risk ratio (RR) 1.02, 95% CI 0.98 
      to 1.06, P = 0.41, I (2) = 0%). Based on the abnormal acid reflux by pH 
      monitoring, its incidence was significantly lower in the SM group than that in 
      the LM group (RR 0.58, 95% CI 0.36 to 0.94, P = 0.03, I (2) = 0%). With respect 
      to procedure-related parameters, the total procedure time of SM was significantly 
      shorter than that of LM (mean difference (MD) -16.30, 95% CI -23.10 to -9.49, P < 
      0.001, I (2) = 68%). CONCLUSIONS: SM and LM are comparable in providing treatment 
      efficacy for achalasia patients, whereas less operation time and lower incidence 
      of post-POEM abnormal esophageal acid exposure are observed in SM.
CI  - Copyright (c) 2022 Han Zhang et al.
FAU - Zhang, Han
AU  - Zhang H
AD  - Department of Gastroenterology, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
FAU - Zeng, Xinyi
AU  - Zeng X
AD  - Department of Gastroenterology, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
FAU - Huang, Shu
AU  - Huang S
AD  - Department of Gastroenterology, The People's Hospital of Lianshui, Huaian, China.
FAU - Xia, Huifang
AU  - Xia H
AD  - Department of Gastroenterology, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
FAU - Shi, Lei
AU  - Shi L
AD  - Department of Gastroenterology, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
FAU - Jiang, Jiao
AU  - Jiang J
AD  - Department of Gastroenterology, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
FAU - Ren, Wensen
AU  - Ren W
AD  - Department of Gastroenterology, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
FAU - Peng, Yan
AU  - Peng Y
AD  - Department of Gastroenterology, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
FAU - Lu, Muhan
AU  - Lu M
AUID- ORCID: 0000-0002-0527-3695
AD  - Department of Gastroenterology, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
FAU - Tang, Xiaowei
AU  - Tang X
AUID- ORCID: 0000-0001-6064-0526
AD  - Department of Gastroenterology, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220330
PL  - Egypt
TA  - Gastroenterol Res Pract
JT  - Gastroenterology research and practice
JID - 101475557
PMC - PMC8986442
COIS- Han Zhang, Xinyi Zeng, Shu Huang, Huifan Xia, Lei Shi, Jiao Jiang, Wensen Ren, 
      Yan Peng, Muhan Lu, and Xiaowei Tang have no conflicts of interest or financial 
      ties to disclose.
EDAT- 2022/04/12 06:00
MHDA- 2022/04/12 06:01
PMCR- 2022/03/30
CRDT- 2022/04/11 05:28
PHST- 2021/11/29 00:00 [received]
PHST- 2022/03/14 00:00 [accepted]
PHST- 2022/04/11 05:28 [entrez]
PHST- 2022/04/12 06:00 [pubmed]
PHST- 2022/04/12 06:01 [medline]
PHST- 2022/03/30 00:00 [pmc-release]
AID - 10.1155/2022/6770864 [doi]
PST - epublish
SO  - Gastroenterol Res Pract. 2022 Mar 30;2022:6770864. doi: 10.1155/2022/6770864. 
      eCollection 2022.