Analysis Of Short-time Efficacy Between POEM And Laparoscopic Heller Myotomy In The Treatment Of Achalasia

Research purposes:In order to guide the treatment of achalasia, evaluating the difference of short-time efficacy and other related factors between POEM and laparoscopic Heller myotomy.Materials and methods:From January 2013 to October 2015, a total of 45 patients with AC are enrolled in the study, who met the inclusion and exclusion criteria and completed the telephone return visit. 15 patients received POEM and 30 patients received LHM.In order to evaluate the relief degree of clinical symptoms, I made the Eckardt score for each patient at the time of postoperative, 1 months, 3 months and 6 months after the operation. Curative effect evaluation standard:postoperative Eckardt score less than 3is defined as effective, the Eckardt score in 6 months after the operation no less than 4is defined as failure, and the Eckardt score of 6 months after the operation higher than4 is defined as recurrence.In this study, we evaluate the effectiveness of the two methods of treatment by comparing the Eckardt score values and trends of preoperative and postoperative. At the same time, the hospital stay, postoperative hospital stay, hospitalization costs, postoperative fasting time, the number of white blood cells and the percentage of neutrophils were compared。Results:45 patients were enrolled in this study. POEM group contains 15 patients. In this group, mean age is(41.40 + 15.96) years old, average course of disease is(3.91 +6.11) years, mean hospitalization is(13.33±5.74) days, the effective rate is 100%(15/15), preoperative Eckardt score averaged(8.33 + 1.84), the averaged Eckardt score of 1 month after operation is(0.13 + 0.35), 3 months after operation is(0.27 +0.59), 6 months after operation is(0.27 + 0.59), P < 0.05, the difference was statistically significant. LHM group contains 30 patients. In this grout, mean age is(44.10±18.29) years old, average course of disease is(6.92±9.06) years, meanhospitalization is(13.60±4.59) days, the effective rate is 93.33(28/30), preoperative Eckardt score averaged(7.63±2.57), the averaged Eckardt score of 1 month after operation is(0.70±1.18), 3 months after operation is(1.00±1.29), 6 months after operation is(1.03±1.40), P < 0.05, the difference was statistically significant.Comparing the two treatment methods before and after the operation, the Eckardt score of the patients with achalasia are decrease, and the difference is not statistically significant(P>0.05). In the analysis of other related factors, POEM surgery required less hospitalization costs and shorter postoperative fasting time compared with laparoscopic Heller myotomy.Conclusion:In the treatment of achalasia, POEM and LHM are both significantly relieve the clinical symptoms, but the difference between the two kind of treatment methods is no statistically significant. In the analysis of other related factors, POEM surgery required less hospitalization costs and shorter postoperative fasting time compared with laparoscopic Heller myotomy.