Analysis Of The Clinical Efficacy Of POEM For Achalasia And Factors Of Post-POEM Reflux

Objective:To analyze the clinical efficacy of POEM treating patient with achalasia and identify risk factors associated with post-POEM reflux.Methods:A retrospective review of database of patients who underwent POEM between April 2015 and February 2019 at the Second Hospital of Hebei Medical University was performed.Demographics along with pre-POEM and post-POEM variables were obtained.And Eckardt score were analysed.Univariate and multivariate analyses were performed for risk factor of post-POEM reflux,using p values ≤ 0.05 for statistical significance.Results:All patients including 40 males and 66 females underwent POEM successfully.Their aged between 21～69,with an average age of 44 years.Postoperative follow-up time was range 1 to 48 months.The Eckardt score of patients with achalasia of post-operative was significantly lower than that of pre-operative(P<0.05).The effective rate was 94.3%,the recurrence rate was 2.8%,the failure rate was 2.8%.There were 34(32.1%,34/106)cases of post-POEM reflux,20(18.9%,20/106)cases of gas-related complications,and 1(0.9%,1/106)cases of adverse events.Age,sex,course of disease and type of esophageal manometry had no influence of post-POEM reflux(P>0.05).Conclusions:1.POEM is safe and effective for the treatment of AC with low recurrenc rate.2.Age,sex,course of disease and type of esophageal manometry could not be indexes of prognosis for the post-POEM reflux.