Weng CY, He CH, Zhuang MY, Xu JL, Lyu B. Peroral endoscopic longer vs shorter esophageal myotomy for achalasia treatment: A systematic review and meta-analysis. World J Gastrointest Surg 2022; 14(3): 247-259 [PMID: 35432766 DOI: 10.4240/wjgs.v14.i3.247]
Corresponding Author of This Article
Bin Lyu, PhD, Professor, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medicine University, No. 54 Youdian Road, Hangzhou 310006, Zhejiang Province, China. lvbin@medmail.com.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2022; 14(3): 247-259 Published online Mar 27, 2022. doi: 10.4240/wjgs.v14.i3.247
Peroral endoscopic longer vs shorter esophageal myotomy for achalasia treatment: A systematic review and meta-analysis
Chun-Yan Weng, Cheng-Hai He, Ming-Yang Zhuang, Jing-Li Xu, Bin Lyu
Chun-Yan Weng, Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Cheng-Hai He, Department of Gastroenterology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310006, Zhejiang Province, China
Ming-Yang Zhuang, Internal Medicine of Chinese Medicine, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Jing-Li Xu, Department of Surgery, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Bin Lyu, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou 310006, Zhejiang Province, China
Author contributions: Weng CY and He CH collected data; Zhuang MY analyzed the data and wrote the first draft of the manuscript; Xu JL and Lyu B were major contributors in editing the manuscript; All authors read and approved the final manuscript.
Supported bythe National Natural Science Foundation of China, No. 8177030774.
Conflict-of-interest statement: The authors declare they have no competing financial and non-financial interests.
PRISMA 2009 Checklist statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Lyu, PhD, Professor, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medicine University, No. 54 Youdian Road, Hangzhou 310006, Zhejiang Province, China. lvbin@medmail.com.cn
Received: September 27, 2021 Peer-review started: September 27, 2021 First decision: December 4, 2021 Revised: December 9, 2021 Accepted: February 16, 2022 Article in press: February 16, 2022 Published online: March 27, 2022 Processing time: 179 Days and 0.9 Hours
ARTICLE HIGHLIGHTS
Research background
For a long time, peroral endoscopic myotomy (POEM) has been demonstrated to be safe and effective in the treatment of achalasia.
Research motivation
Longer myotomy is the standard POEM procedure for achalasia, but its effectiveness compared with shorter myotomy is not well known. Thus, we want to provide an analysis to assess the clinical outcomes of shorter and longer myotomy.
Research objectives
To conduct a meta-analysis to compare the clinical effectiveness of the two procedures.
Research methods
The PubMed, Web of Science, Cochrane Library, clinicaltrials.gov, and EMBASE databases were used to search for relevant studies to compare shorter and longer myotomy in POEM for achalasia treatment.
Research results
Longer and shorter myotomy groups in treating achalasia had similar excellent effectiveness. Shorter myotomy had significantly reduced mean operative time compared with the longer procedure. There were no statistically significant differences in AE’s rates, including gastroesophageal reflux diseases, hospital stay and major bleeding between the two procedures.
Research conclusions
Short myotomy has the advantage of shorter procedure time in the treatment of achalasia compared to long myotomy, but the clinical success rate, adverse events , and reflux rate were comparable.
Research perspectives
Future randomized clinical trials should determine whether the benefits remain comparable after years of follow-up.
