经口内镜下肌切开术治疗贲门失弛缓症术后复发的危险因素

目的:分析经口内镜下肌切开术(peroral endoscopic myotomy,POEM)治疗贲门失弛缓症术后复发的相关危险因素。方法:回顾性分析2012年2月至2017年12月东部战区总医院消化内科86例诊断为贲门失弛缓症并接受POEM手术治疗患者的临床资料,采用单因素和多因素logistic回归分析的方法,分析POEM术后贲门失迟缓症复发的相关危险因素。结果:19例患者POEM术后出现复发,复发率为22.1%。单因素分析显示:病程、Chicago分型与POEM术后贲门失弛缓症复发相关(P<0.05)。Logistic回归分析显示:病程是POEM术后发生贲门失迟缓症复发的独立危险因素(OR=0.780,95%CI:0.624~0.975,P=0.029)。结论:病程、Chicago分型与POEM术后贲门失弛缓症复发密切相关,病程是POEM术后贲门失迟缓症复发的独立危险因素。

Risk factors for recurrence of achalasia after peroral endoscopic myotomy

Objective:To analyze the risk factors of postoperative recurrence of achalasia treated with peroral endoscopic myotomy(POEM).Methods:The clinical data of 86 patients diagnosed with achalasia and treated with POEM in our department from February 2012 to December 2017 were retrospectively analyzed,and univariate and multivariate logistic regression analysis was conducted to analyze the related risk factors of recurrence of achalasia after POEM.Results:Postoperative recurrence occurred in 19 patients,with a recurrence rate of 22.1%.Univariate analysis showed that the course of disease and the classification of Chicago were related to the recurrence of achalasia after POEM(P<0.05).Logistic regression analysis showed that the course of disease was an independent risk factor for recurrence of cardiac retardation after POEM(OR=0.780,95% CI:0.624–0.975,P=0.029).Conclusion:The course of disease and the classification of Chicago are closely related to the recurrence of achalasia after POEM.The course of disease is an independent risk factor for the recurrence of achalasia after POEM.