Comparison of POEM surgery and pneumatic dilation in the treatment of achalasia of cardia

LIU Jingyang; ZHU Yanjie; SHAO Jing; XU Ruiling; WANG Shuang; LIU Bingrong

doi:10.3969/j.issn.1671-6450.2018.01.014

Abstract：Objective To compare effect of POEM surgery and pneumatic dilation in the treatment of achalasia of cardia.Methods Ninety cases of patients with achalasia of cardia were selected,which were treated in hospital from March 2015 to March 2016,and they were divided into the POEM group (45 cases) and PD group (45 cases)according to the different surgical methods.Compare the surgical general condition,complication and changes of the levels of LESP,LESRR,4s IRP,the degree of symptom relief and esophageal dilatation of two groups.Results The operative time,hospital stay of the POEM group were significantly longer than those of the PD group(t =9.895,t =6.130;P=0.O00,P =0.000);After the treatment for 3 months,the LESP,4s IRP levels of the POEM group were significantly lower than those of the PD group,and the LESRR levels of the POEM group were significantly higher than those of the PD group(t =4.783,t =4.068,t =4.742;P =0.000,P =0.000,P =0.000);The Eckardt scores,esophageal dilatation of the POEM group were all significantly lower than those of the PD group after treatment for 3 months and one year (t =7.829,t =5.975,t =6.718,t =7.488;P =0.000,P =0.000,P =0.000,P =0.000);There were perforation,bleeding,infection,chest pain,subcutaneous emphysema,pneumothorax,food reflux and other complications occurred in both two groups,but there were no statistically significant between the two groups (x2 =0.758,=2.381,0.875,0.758,0.505,0.981,2.224;P＞0.05).Conclusion PD surgery is relatively simple,with good safety.Compared with PD surgery,POEM surgery can effectively improve the esophageal function of patients with achalasia of cardia,reduce the pressure of LES,and reduce the dysphagia,which is conducive to the alleviation of clinical symptoms.