摘要
目的比较分析腹腔镜下Heller肌切开术与经口内镜下肌切开术(POEM)治疗贲门失弛缓症(AC)的疗效,为临床治疗选择提供依据。方法搜索知网、Embase、Pub Med等数据库中有关AC以及采用腹腔镜下Heller肌切开术与POEM治疗的相关文献,并对其中涉及到疗效及并发症的条目进行整理并进行综述。结果AC的治疗方式主要包括以腹腔镜下Heller肌切开术为主的外科治疗以及POEM为主的内镜治疗,这两种治疗术式的全面比较仍缺乏大量的相关数据,两种术式的选择仍存在争议。从目前已有的文献报道来看,无论从并发症、近期疗效等方面POEM均优于腹腔镜下Heller肌切开术,但其远期疗效比较仍不明确。结论腹腔镜下Heller肌切开术与POEM两种方式治疗AC均有效,POEM作为AC的一种较新的术式,体现了其创伤小、疗效确切,但其远期预后仍需要长期的随访研究。目前临床医生可根据患者AC的内镜下分型、患者自身体质、食管走行状况、既往治疗史,手术的耐受性等因素综合考虑选择合适的治疗方案。
Objective To compare effectiveness between laparoscopic Heller myotomy and peroral endoscopic myotomy （POEM） in treatment of achalasia of cardia （AC） in order to provide a basis for clinical choose. Method The literatures about the treatment of AC by laparoscopic Heller myotomy or POEM were retrieved from CNKI, Embase, PubMed databases, etc., and then the contents about curative effect and complications were summarized. Results The treatment models of AC included surgical treatment such as laparoscopic Heller myotomy and endoscopy such as POEM, but there was still lack of comparing data in these two treatment models, its selection remained controversial. There was a better short-term curative effect and slighter complications for POEM as compared with the laparoscopic Heller myotomy from the trend of published literatures. However, it＇s long-term effects for these two treatment models were not clarified. Conclusions Both laparoscopic Heller myotomy and POEM are medicable for AC. POEM as a new treatment of AC shows some advantages of minimal invasion and exact efficacy, but it needs to be followed-up for a longterm. Treatment model for AC is chosen on basis of typing under endoscope, physical fitness, anatomy of easophagus, previous history, tolerance of surgery and other factors.
出处
《中国普外基础与临床杂志》
CAS
2017年第8期1025-1029,共5页
Chinese Journal of Bases and Clinics In General Surgery
基金
国家自然科学基金项目(项目编号:81360370)
广西自然科学基金面上项目(项目编号:2016GXNFSFAA380180)
广西卫生厅自筹课题(项目编号:Z2015526)
